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. 2016 Nov;29(22):3646-51.
doi: 10.3109/14767058.2016.1140734. Epub 2016 Feb 26.

The Common Vaginal Commensal Bacterium Ureaplasma Parvum Is Associated With Chorioamnionitis in Extreme Preterm Labor

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The Common Vaginal Commensal Bacterium Ureaplasma Parvum Is Associated With Chorioamnionitis in Extreme Preterm Labor

Ciara Cox et al. J Matern Fetal Neonatal Med. .

Abstract

Objective: To assess the association of vaginal commensal and low-grade pathogenic bacteria including Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, Group B streptococcus (GBS), and Gardnerella vaginalis, in women who delivered preterm at less than 37-week gestation in the presence or absence of inflammation of the chorioamnionitic membranes.

Methods: A case control study involving women who delivered before 37-week gestation with and without inflammation of chorioamnionitic membranes. A total of 57 placental samples were histologically examined for polymorphonuclear leukocyte infiltration of placental tissue for evidence of chorioamnionitis, and by type-specific nucleic acid amplification for evidence of infection with one or more of the target bacteria. Demographic data were collected for each mother.

Results: Among the 57 placental samples, 42.1% had chorioamnionitis and 24.6% delivered in the second trimester of pregnancy; U. parvum, U. urealyticum, G. vaginalis, and GBS were all detected in the study with respective prevalence of 19.3%, 3.5%, 17.5%, and 15.8%; M. genitalium and M. hominis were not detected. U. parvum was significantly associated with chorioamnionitis (p = 0.02; OR 5.0; (95% CI 1.2-21.5) and was more common in women who delivered in the second (35.7%) compared to the third trimester of pregnancy (13.9%). None of the other bacteria were associated with chorioamnionitis or earlier delivery, and all G. vaginalis-positive women delivered in the third trimester of pregnancy (p = 0.04).

Conclusions: The detection of U. parvum in placental tissue was significantly associated with acute chorioamnionitis in women presenting in extreme preterm labor.

Keywords: Bacteria; PCR; Ureaplasma; intra-amniotic; placenta; pregnancy; prematurity; trimester.

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