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First Trimester Vaginal Ureaplasma Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study
Judith Rittenschober-Böhm1, Thomas Waldhoer, Stefan M Schulz
1Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Vienna, Austria.
Neonatology
|September 22, 2017
Summary
First-trimester vaginal colonization with Ureaplasma parvum (U. parvum) significantly increases the risk of spontaneous preterm birth (SPB). Ureaplasma urealyticum colonization did not show a significant association with SPB.
Area of Science:
- Reproductive Health
- Microbiology
- Obstetrics
Background:
- The link between Ureaplasma infection and adverse pregnancy outcomes is established for the upper genital tract.
- The impact of vaginal Ureaplasma colonization on preterm birth remains debated.
Purpose of the Study:
- To investigate the association between vaginal Ureaplasma parvum and Ureaplasma urealyticum colonization and spontaneous preterm birth (SPB).
- To determine if U. parvum colonization, independent of U. urealyticum, increases SPB risk.
Main Methods:
- Vaginal swabs from 4,330 pregnant women were analyzed for Ureaplasma biovars using PCR between 12-14 weeks of gestation.
- Statistical analyses, including logistic regression, were used to assess the risk of SPB.
Main Results:
- 37% of women were colonized with U. parvum, 5.9% with U. urealyticum, and 3.1% with both.
- U. parvum colonization was associated with a significant increase in SPB rates (OR 1.7, p < 0.001).
- U. urealyticum colonization did not show a statistically significant association with SPB (OR 1.4, p = 0.193).
- Vaginal U. parvum colonization remained a significant risk factor for SPB after adjusting for other factors (aOR 1.6, p < 0.001).
Conclusions:
- First-trimester vaginal colonization with U. parvum is a significant and independent risk factor for spontaneous preterm birth.
- U. urealyticum colonization does not appear to be associated with an increased risk of SPB.