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Ureaplasma urealyticum and premature birth
1Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.
Summary
Ureaplasma urealyticum in the lower genital tract does not increase premature birth risk. However, its presence in the chorioamnion is linked to preterm birth and histological chorioamnionitis.
Area of Science:
- Obstetrics and Gynecology
- Microbiology
- Perinatal Medicine
Background:
- Ureaplasma urealyticum is a common vaginal bacterium in pregnant individuals, found in approximately 70% of cases.
- The association between Ureaplasma urealyticum and adverse pregnancy outcomes, particularly premature birth, remains a subject of investigation.
Purpose of the Study:
- To review existing evidence on the association between Ureaplasma urealyticum and premature birth.
- To differentiate the role of Ureaplasma urealyticum in the lower genital tract versus intra-amniotic or chorioamnion infections.
Main Methods:
- Systematic review of published reports and studies.
- Analysis of Ureaplasma urealyticum recovery from different sample sites (vagina, amniotic fluid, chorioamnion).
- Correlation of bacterial presence with gestational age at birth and histological findings.
Main Results:
- Ureaplasma urealyticum in the vagina is not linked to premature birth.
- Eradication therapy for vaginal Ureaplasma urealyticum during pregnancy does not lower preterm birth rates.
- Recovery from amniotic fluid shows no association with prematurity.
- Ureaplasma urealyticum in the chorioamnion is weakly associated with prematurity and strongly with histological chorioamnionitis.
Conclusions:
- Ureaplasma urealyticum colonization of the lower genital tract during pregnancy is not a risk factor for premature birth.
- Intrauterine presence of Ureaplasma urealyticum, specifically in the chorioamnion, is associated with increased risk of preterm delivery and infection of the placental membranes.