Subclinical chorioamnionitis as an etiologic factor in preterm deliveries

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Infectious Disease in Pregnancy

Background:

• Histologic chorioamnionitis is a known complication of pregnancy.
• Genital tract infections are frequently observed in pregnant women.
• The relationship between these factors and preterm delivery requires further elucidation.

Purpose of the Study:

• To investigate the association between histologic chorioamnionitis and genital tract cultures.
• To determine the contribution of these factors to preterm delivery.

Main Methods:

• A cohort of 45 preterm and 37 term pregnancies was studied.
• Cervico-vaginal cultures were obtained upon admission.
• Placentas underwent histopathological evaluation for inflammation (chorionic plate, amniochorionic membrane, umbilical cord, villi).

Main Results:

• Severe chorionic plate inflammation was significantly higher in preterm deliveries (35.5%) versus term deliveries (5.4%).
• Amniochorionic-decidual inflammation was more prevalent and severe in preterm pregnancies (P<0.05).
• Pathogenic bacteria were consistently found in lower genital tracts of patients with severe placental inflammation (P<0.001 for CP, P<0.01 for CA).

Conclusions:

• Pathogenic bacterial colonization of the cervicovaginal region is strongly associated with placental inflammation.
• This association highlights a potential pathway contributing to preterm labor.
• Cervico-vaginal cultures may serve as a valuable tool for identifying pregnancies at risk for preterm delivery.