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The severity of fetal membrane infection and pregnancy complications
M A Krohn1, S L Hillier, N B Kiviat
1Department of Epidemiology, University of Washington, Seattle 98195.
Abstract:
The purpose of this report is to examine the association of histologic chorioamnionitis with microorganisms isolated from the fetal membranes and to evaluate whether microorganisms with or without inflammation are associated with labor characteristics and with pregnancy complications. Inflammation was more common among membranes that yielded pathogenic bacteria (47%, P = 0.002) or Urea-plasma urealyticum (34%, P = 0.03) than among membranes that yielded no growth or nonpathogenic bacteria (20%). Prolonged membrane rupture (P = 0.0001), infant birth weight less than 2500 g (P = 0.02), and intraamniotic infection (P = 0.001) occurred more frequently among those women whose membranes yielded pathogenic bacteria than among those whose membranes yielded no growth or nonpathogenic bacteria. Our findings suggest that placental membranes in which pathogenic bacteria are accompanied by inflammation are associated with the highest risk of pregnancy complications.
Insights
Histologic chorioamnionitis, indicated by pathogenic bacteria in placental membranes, significantly increases the risk of pregnancy complications. Inflammation alongside these bacteria poses the highest risk, impacting labor and infant outcomes.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases in Pregnancy
- Perinatal Medicine
Background:
- Histologic chorioamnionitis is a placental inflammation often linked to intrauterine infections.
- The role of specific microorganisms and their association with inflammation in pregnancy outcomes requires further elucidation.
Purpose of the Study:
- To investigate the link between microorganisms in fetal membranes and histologic chorioamnionitis.
- To assess if microorganisms, with or without inflammation, correlate with labor characteristics and pregnancy complications.
Main Methods:
- Analysis of microorganisms isolated from fetal membranes.
- Correlation of microbial findings and presence of inflammation with labor characteristics and pregnancy complications.
Main Results:
- Inflammation was significantly more prevalent in membranes with pathogenic bacteria (47%) or Ureaplasma urealyticum (34%) compared to those with no growth or nonpathogenic bacteria (20%).
- Pathogenic bacteria in membranes were associated with increased rates of prolonged membrane rupture (P = 0.0001), low infant birth weight (<2500 g, P = 0.02), and intraamniotic infection (P = 0.001).
- The highest risk for pregnancy complications was observed when pathogenic bacteria were present with inflammation in placental membranes.
Conclusions:
- The presence of pathogenic bacteria in placental membranes, especially when accompanied by inflammation, is a significant risk factor for adverse pregnancy outcomes.
- Microbial presence and associated inflammation are critical indicators for predicting labor characteristics and potential pregnancy complications.