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Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants

Hiroyuki Kitajima1,2, Masanori Fujimura2, Makoto Takeuchi3

  • 1Department of Developmental Medicine, Research Institute, Osaka Women's and Children's Hospital, Osaka, Japan.

Pediatric Pulmonology
|August 5, 2022
PubMed

Insights

Intrauterine Ureaplasma infection in extremely preterm infants is linked to long-term lung issues like small airway obstructions. This study highlights the impact of prenatal factors on respiratory health in premature infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Infectious Disease

Background:

  • Bronchopulmonary dysplasia (BPD) is a chronic lung disease in extremely preterm (EP) infants.
  • Small airway obstructions (SAO) are increasingly observed in EP infants with BPD long-term.
  • Understanding prenatal risk factors for BPD and SAO is crucial for improving infant outcomes.

Purpose of the Study:

  • To investigate the association between intrauterine Ureaplasma infection and lung function abnormalities in EP infants.
  • To determine the relationship between Ureaplasma infection, cystic lung changes, BPD severity, and SAO at school age.

Main Methods:

  • A cohort of 360 EP infants born between 1981-2004 was studied.
  • Placental pathology, Ureaplasma DNA (pU-DNA), and cord blood IgM (C-IgM) were analyzed.
  • Maternal amniotic inflammatory response (M-AIR) scores and hemosiderin deposition (HD) were assessed.
  • Lung function at school age was compared to healthy siblings.

Main Results:

  • Intrauterine Ureaplasma (pU-DNA) and elevated C-IgM were significantly linked to SAO at school age.
  • High M-AIR scores and pU-DNA levels were associated with increased odds of cystic lung, severe BPD, and SAO.
  • Factors like BPD severity, oxygen use, HD, and C-IgM levels also correlated with SAO.

Conclusions:

  • Intrauterine Ureaplasma infection is a significant risk factor for long-term lung complications in EP infants.
  • Prenatal inflammation and infection can lead to structural lung changes and impaired lung function later in life.
  • Early identification and management of intrauterine infections may help prevent chronic respiratory diseases in preterm infants.
Abstract

Keywords:
Ureaplasmabronchopulmonary dysplasiabubbly/cystic lungextremely preterm infantsmall airway obstruction

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