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Microorganisms and premature labor
1Department of Obstetrics and Gynecology, Quillen-Dishner College of Medicine, East Tennessee State University, Johnson City 37614.
Abstract:
A number of organisms, including Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae and Chlamydia trachomatis, have been isolated more frequently from patients in premature labor than from controls. Prophylactic antibiotic treatment in some studies lowered the incidence of prematurity. Silent chorioamnionitis has been noted in 15% of patients in premature labor. Untreated pyelonephritis is clearly associated with premature labor; however, the association of asymptomatic bacteriuria, appropriately treated pyelonephritis and premature labor is less clear. Some microorganisms have been demonstrated to produce phospholipase A2 and possibly prostaglandins, which might be the mechanism for some of the associations between premature labor and bacteria.
Insights
Certain bacteria, like Mycoplasma and Chlamydia trachomatis, are linked to premature labor. Prophylactic antibiotics may reduce prematurity rates, and microbial phospholipase A2 or prostaglandins could be involved mechanisms.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Microbiology
Background:
- Premature labor is a significant concern in obstetrics.
- Several microorganisms have been frequently isolated from patients experiencing premature labor compared to controls.
- Silent chorioamnionitis is observed in a notable percentage of premature labor cases.
Purpose of the Study:
- To investigate the association between various microorganisms and premature labor.
- To explore the potential role of microbial byproducts in the pathogenesis of premature birth.
- To review the impact of antibiotic treatment on the incidence of prematurity.
Main Methods:
- Microbiological cultures to identify organisms in premature labor patients and controls.
- Review of studies on prophylactic antibiotic treatment efficacy.
- Analysis of the association between urinary tract infections (pyelonephritis, asymptomatic bacteriuria) and premature labor.
- Investigation of microbial production of phospholipase A2 and prostaglandins.
Main Results:
- Organisms such as Mycoplasma, group B Streptococcus, Bacteroides, Neisseria gonorrhoeae, and Chlamydia trachomatis were more prevalent in premature labor patients.
- Prophylactic antibiotic treatment showed a reduced incidence of prematurity in some studies.
- Untreated pyelonephritis demonstrated a clear association with premature labor, while the link for asymptomatic bacteriuria and treated pyelonephritis was less defined.
- Certain microbes can produce phospholipase A2 and prostaglandins, potentially mediating premature labor.
Conclusions:
- Specific bacterial and other microbial infections are frequently associated with premature labor.
- Antibiotic interventions may play a role in preventing premature birth.
- Microbial enzymes and metabolites, such as phospholipase A2 and prostaglandins, are implicated as potential mechanisms linking infection to preterm delivery.