Severe Neonatal Asphyxia Associated with Ureaplasma urealyticum Infection: A Case Report

BACKGROUND Ureaplasma urealyticum (UU) is a common microorganism that has been associated with a variety of obstetric and neonatal complications, such as infertility, stillbirth, histologic chorioamnionitis, neonatal sepsis, respiratory infections, and central nervous system infections. However, it is rare for it to cause severe neonatal asphyxia. This rarity is the focus of our case report, which aims to highlight the potential severity of UU infections in newborns. CASE REPORT A male neonate was delivered vaginally at 40+5 weeks of gestation, with a history of premature rupture of membranes at 7 hours and low amniotic fluid volume. After birth, he had no spontaneous breathing at birth, with cyanosis around the mouth and extremities and flaccid limbs. The Apgar score was a low 3, indicating severe asphyxia. Immediate medical interventions were undertaken, including cardiopulmonary resuscitation, tracheal intubation, and airway clearing. Despite these efforts, the newborn required transfer to our hospital with the assistance of an invasive ventilator. Upon admission, UU DNA was detected in the sputum at 3.25×10⁴ copies/mL. He received erythromycin for infection, mechanical ventilation, milrinone combined with sildenafil to reduce pulmonary arterial hypertension, and glycerol fructose to reduce intracranial pressure. Although these treatments successfully controlled the infection, the infant suffered significant neurological damage. Tragically, the family decided to cease treatment, and the neonate died at 12 days of age. CONCLUSIONS Ureaplasma urealyticum infection can cause severe neonatal asphyxia. We report the present case to raise awareness about the importance of early detection and intervention for UU in pregnant women to improve maternal and neonatal outcomes.