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Association of Ureaplasma urealyticum in the placenta with perinatal morbidity and mortality
Abstract:
We investigated the presence of ureaplasmas, mycoplasmas, chlamydiae, fungi, aerobic and anaerobic bacteria, and cytomegalovirus in fetal membranes and evaluated their association with perinatal morbidity and mortality. We cultured 801 placentas from three groups of subjects (144 who died in the perinatal period, 452 neonates admitted to the intensive-care unit, and 205 controls). Ureaplasma urealyticum, Mycoplasma hominis, or both were isolated from 21 per cent of placentas of premature and term infants who died in the perinatal period, 25 per cent of those admitted to intensive care, and 11 per cent of controls. Gestational age and birth weight were inversely related to isolation of ureaplasma, and chorioamnionitis was positively related to isolation. The presence of ureaplasmas in the placenta suggests the transcervical migration of these microorganisms from the lower genitourinary tract. These data show a strong association between ureaplasma infection of the placenta and low birth weight of the neonate and suggest that the association is causal.
Insights
Ureaplasma infection in placentas is linked to adverse perinatal outcomes. This study found a strong causal association between placental ureaplasma and low birth weight in neonates.
Area of Science:
- Microbiology
- Perinatology
- Obstetrics
Background:
- Infections during pregnancy can lead to serious complications.
- The role of specific microorganisms like ureaplasmas in perinatal outcomes requires further investigation.
Purpose of the Study:
- To investigate the presence of various microorganisms in fetal membranes.
- To evaluate the association between these infections and perinatal morbidity and mortality.
Main Methods:
- Culturing of 801 placentas from three groups: perinatal deaths, intensive care unit neonates, and controls.
- Microbiological analysis for ureaplasmas, mycoplasmas, chlamydiae, fungi, bacteria, and cytomegalovirus.
Main Results:
- Ureaplasma urealyticum or Mycoplasma hominis were isolated from 21% of placentas in perinatal deaths, 25% in ICU admissions, and 11% in controls.
- Isolation rates of ureaplasma were inversely related to gestational age and birth weight.
- Chorioamnionitis showed a positive correlation with ureaplasma isolation.
Conclusions:
- Placental ureaplasma infection is strongly associated with low birth weight, suggesting a causal link.
- Transcervical migration from the genitourinary tract is a likely route for ureaplasma infection.