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Chorioamnionitis and colonization of the newborn infant with genital mycoplasmas
Abstract:
To study the role of Mycoplasma hominis and T-mycoplasmas (Ureaplasma urealyticum) in chorioamnionitis, we obtained culture from 249 puerperal women and their babies. The placentas were examined histologically. Infants whose placentas showed inflammation (chorioamnionitis) had cultures positive for T-mycoplasmas more frequently (37.5 per cent) than those with normal placentas (19.0 per cent) (P = 0.021). Colonization with M. hominis was found in 16.0 per cent of the babies and was not significantly associated with chorioamnionitis. Material colonization with mycoplasmas was more frequent (73.4 per cent) and was not correlated with placental inflammation. We conclude that a substantial proportion of cases of chorioamnionitis may be caused by prenatal infection with T-mycoplasmas. The fact that these organisms are not highly virulent could explain the frequent finding of inflammed placentas from otherwise normal pregnacies. No adverse clinical effects of the placental lesions or of mycoplasmal colonization could be detected in this small study.
Insights
T-mycoplasmas, including Ureaplasma urealyticum, are frequently linked to chorioamnionitis, a placental inflammation. Prenatal T-mycoplasma infection may cause a significant portion of these cases, even in otherwise normal pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Microbiology
Background:
- Chorioamnionitis is a significant complication of pregnancy.
- The role of specific microorganisms, such as Mycoplasma hominis and T-mycoplasmas (Ureaplasma urealyticum), in chorioamnionitis requires further elucidation.
Purpose of the Study:
- To investigate the association between Mycoplasma hominis and T-mycoplasmas (Ureaplasma urealyticum) and chorioamnionitis.
- To determine the prevalence of mycoplasma colonization in puerperal women and their neonates in relation to placental inflammation.
Main Methods:
- Cultures were obtained from 249 puerperal women and their neonates.
- Placental tissues were examined histologically to diagnose chorioamnionitis.
- Statistical analysis was performed to correlate mycoplasma presence with placental inflammation and clinical outcomes.
Main Results:
- Infants with chorioamnionitis showed significantly higher rates of T-mycoplasma positivity (37.5%) compared to those with normal placentas (19.0%).
- Mycoplasma hominis colonization was found in 16.0% of neonates but was not significantly associated with chorioamnionitis.
- Overall mycoplasma colonization was frequent (73.4%) but not correlated with placental inflammation.
Conclusions:
- Prenatal T-mycoplasma (Ureaplasma urealyticum) infection is a likely cause of a substantial proportion of chorioamnionitis cases.
- The low virulence of T-mycoplasmas may explain the presence of placental inflammation in otherwise uncomplicated pregnancies.
- This study found no detectable adverse clinical effects associated with placental lesions or mycoplasma colonization in the studied cohort.