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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
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Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats

Published on: November 20, 2015

Infectious disease and perinatal morbidity

E H Kass

    The Yale Journal of Biology and Medicine
    |May 1, 1982
    PubMed

    Insights

    Infections during pregnancy, including asymptomatic bacteriuria and genital mycoplasmas, contribute to preterm birth and low birth weight. Early screening and treatment of these infections can significantly reduce adverse perinatal outcomes.

    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.

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