Antenatal exposure to Ureaplasma species exacerbates bronchopulmonary dysplasia synergistically with subsequent prolonged mechanical ventilation in preterm infants

Pediatr Res. 2012 Mar;71(3):267-73. doi: 10.1038/pr.2011.47. Epub 2012 Jan 18.


Introduction: The presence of microorganisms in gastric fluid in neonates at birth is postulated to reflect antenatal infection and also to be associated with the development of bronchopulmonary dysplasia (BPD).

Results: A logistic regression analysis, after controlling for other risk factors, indicated that Ureaplasma-positive infants were not at increased risk for moderate/severe BPD (adjusted odds ratio (OR): 2.58, 95% confidence interval (CI): 0.57-6.89, P = 0.12). However, the association between the presence of Ureaplasma species and the risk for moderate/severe BPD increased significantly in infants on mechanical ventilation (MV) ≥2 wk (adjusted OR: 4.17, 95% CI: 1.62-44.1, P = 0.009). An analysis using a lung injury marker indicated that Ureaplasma-positive infants with MV ≥2 wk, but not other infants, showed higher serum KL-6 levels in samples taken from cord blood, and that KL-6 levels increased time-dependently up to 4 wk of age.

Discussion: Antenatal exposure to Ureaplasma species induces lung injury prior to birth and synergistically contributes to the development of BPD in infants requiring prolonged MV (≥2 wk).

Methods: We recovered gastric fluid specimens from 122 infants with gestational age (GA) <29 wk or birth weight <1,000 g to investigate whether these microorganisms influence respiratory outcome of BPD. A PCR analysis was used to detect urease and 16S ribosomal RNA (rRNA) genes to classify neonates into Ureaplasma-positive or Ureaplasma-negative infants.

MeSH terms

  • Biomarkers / blood
  • Body Fluids / microbiology
  • Bronchopulmonary Dysplasia / epidemiology*
  • Bronchopulmonary Dysplasia / therapy*
  • Female
  • Fetal Blood
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Logistic Models
  • Male
  • Mucin-1 / blood
  • Pregnancy
  • Prenatal Exposure Delayed Effects / physiopathology*
  • Respiration, Artificial*
  • Retrospective Studies
  • Risk Factors
  • Ureaplasma Infections / complications*
  • Ureaplasma* / isolation & purification


  • Biomarkers
  • MUC1 protein, human
  • Mucin-1