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Maternal Ureaplasma exposure during pregnancy and the risk of preterm birth and BPD: a meta-analysis
Yan-Ping Xu1, Jian-Miao Hu2, Ye-Qing Huang3
1NICU, The Children's Hospital, Zhejiang University School of Medicine and National Clinical Research Center for Child Health, Hangzhou, China. xuyanping726@zju.edu.cn.
Insights
Perinatal Ureaplasma infection is linked to increased risks of preterm birth, chorioamnionitis, premature rupture of membranes (PROM), and bronchopulmonary dysplasia (BPD) in preterm infants. Further high-quality research is needed to confirm these associations.
Area of Science:
- Neonatal infectious diseases
- Perinatal medicine
- Respiratory health in preterm infants
Background:
- Perinatal Ureaplasma infection is a known risk factor for adverse neonatal outcomes.
- Bronchopulmonary dysplasia (BPD) is a significant cause of morbidity in preterm infants.
- The association between Ureaplasma and adverse pregnancy outcomes requires further investigation.
Approach:
- A systematic meta-analysis was conducted to evaluate existing evidence.
- Published cohort studies were identified through comprehensive database searches (PubMed, Cochrane Library, Embase).
- Data from 19 cohort studies involving 11,990 pregnancies were synthesized using random/fixed-effect models.
Key Points:
- Pregnancy Ureaplasma positivity was associated with a significantly increased risk of preterm birth (OR 2.76).
- Ureaplasma infection correlated with higher rates of BPD (OR 2.39), chorioamnionitis (OR 2.71), and PROM (OR 2.19).
- The identified evidence base for these associations is of low quality.
Conclusions:
- Ureaplasma infection during pregnancy may elevate the risk of preterm birth, chorioamnionitis, PROM, and BPD in neonates.
- The current evidence suggests a link between Ureaplasma and adverse pregnancy and neonatal outcomes.
- High-quality, well-designed studies are essential to strengthen the evidence base and confirm these findings.
Purpose:
Perinatal Ureaplasma infection is associated with a variety of adverse outcomes and neonatal diseases. This meta-analysis is to evaluate current evidence evaluating the association between Ureaplasma and adverse pregnancy outcomes and bronchopulmonary dysplasia (BPD) in preterm infants.
Methods:
We searched for published articles on Ureaplasma, preterm and BPD in PubMed, the Cochrane Library, and Embase databases posted before August 28, 2021. In addition, the references of these articles were screened. A random/fixed-effect model was used to synthesize predefined outcomes.
Results:
A total of 19 cohort studies involving 11,990 pregnancy women met our inclusion criteria. Pregnancy Ureaplasma positive increased the risk of preterm birth [odds ratios (OR) 2.76, 95% confidence intervals (CI) 1.63-4.68], BPD (OR 2.39 95% CI 1.73-3.30), chorioamnionitis (OR 2.71, 95% CI 2.02-3.64) and premature rupture of membranes (PROM, OR 2.19, 95% CI 1.34-3.58).
Conclusions:
Pregnancy Ureaplasma positive may increase the risk of developing preterm birth, chorioamnionitis, PROM and BPD in the preterm infant. The evidence base is, however, of low quality and well-designed studies are needed.
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