Infectious disease and perinatal morbidity

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Infectious Diseases

Background:

• Perinatal morbidity and mortality remain significant global health challenges, with most deaths occurring in low birth weight infants.
• While neonatal mortality has decreased, rates of prematurity have not improved, indicating a need to address underlying causes.
• Infections during pregnancy are increasingly recognized as a critical, yet often overlooked, factor contributing to prematurity and low birth weight.

Purpose of the Study:

• To investigate the role of bacterial and mycoplasma infections in causing prematurity and low birth weight.
• To evaluate the effectiveness of screening and treatment strategies for these infections in improving perinatal outcomes.
• To highlight the importance of addressing genitourinary infections in pregnant women to reduce adverse neonatal outcomes.

Main Methods:

• Review of existing literature on the association between urinary tract infections (UTIs), asymptomatic bacteriuria, and genital mycoplasmas with perinatal complications.
• Analysis of studies examining the impact of treating symptomatic pyelonephritis and asymptomatic bacteriuria during pregnancy.
• Examination of evidence regarding the role of Ureaplasma urealyticum and Mycoplasma hominis in preterm birth and the outcomes of their treatment.

Main Results:

• Symptomatic pyelonephritis in pregnancy is linked to increased rates of prematurity, perinatal death, and long-term neurodevelopmental issues in offspring.
• Asymptomatic bacteriuria, when untreated, elevates risks for low birth weight, perinatal mortality, and progression to symptomatic UTIs.
• Treatment of asymptomatic bacteriuria and colonization with genital mycoplasmas (Ureaplasma urealyticum, Mycoplasma hominis) has demonstrated a significant reduction in prematurity rates.

Conclusions:

• Genitourinary infections, both symptomatic and asymptomatic, are significant contributors to preventable perinatal morbidity and mortality.
• Routine screening for asymptomatic bacteriuria and genital mycoplasmas, followed by appropriate treatment, is crucial for improving pregnancy outcomes.
• Addressing infectious causes of prematurity is essential for reducing adverse neonatal outcomes and improving infant neurodevelopmental health.