Startseite Association between genital mycoplasmas, acute chorioamnionitis and fetal pneumonia in spontaneous abortions
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

Association between genital mycoplasmas, acute chorioamnionitis and fetal pneumonia in spontaneous abortions

  • Maria Agnese Latino , Giovanni Botta , Claudia Badino , Daniela De Maria , Annalisa Petrozziello , Alessandra Sensini und Christian Leli ORCID logo EMAIL logo
Veröffentlicht/Copyright: 25. Mai 2017

Abstract

Aim:

Ureaplasma parvum, Ureaplasma urealyticum and Mycoplasma hominis are also known as genital mycoplasmas. Acute chorioamnionitis is an inflammation of the placenta associated with miscarriage. We retrospectively evaluated a possible association between genital mycoplasmas detection, acute chorioamnionitis and fetal pneumonia from second and third trimester spontaneous abortions.

Methods:

One hundred and thirty placenta and fetal lung samples were evaluated for histological examination. The placenta samples, along with corresponding fetal tracheo-bronchial aspirates, also underwent bacterial and fungal culture and real-time polymerase chain reaction (PCR) assay for the detection of genital mycoplasmas.

Results:

Acute chorioamnionitis and pneumonia were diagnosed in 80/130 (61.5%) and 22/130 (16.9%) samples, respectively. Among samples positive for acute chorioamnionitis, the proportion of samples positive by real-time PCR and/or culture, was significantly higher than that of negative controls [54/80 (67.5%) vs. 26/80 (32.5%); P<0.001]. Ureaplasma parvum detection was significantly associated with acute chorioamnionitis compared to controls [9/11 (81.8%) vs. 2/11 (18.2%); P=0.019], as well as U. urealyticum [6/7 (85.7%) vs. 1/7 (14.3%); P=0.039]. Among tracheo-bronchial aspirates from abortions with pneumonia, the proportion of real-time PCR and/or culture positive samples was significantly higher than that of controls [13/22 (59.1%) vs. 9/22 (40.9%); P=0.029].

Conclusions:

A strong association was found between acute histologic chorioamnionitis and microbial invasion with U. parvum and/or U. urealyticum.


Corresponding author: Christian Leli, MD, Unit of Microbiology and Virology, University Hospital of Parma, Via Gramsci 14, 43126 Parma, Italy

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human use has been complied with all the relevant national regulations, institutional policies and in accordance the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

References

[1] Waites KB, Katz B, Schelonka RL. Mycoplasmas and ureaplasmas as neonatal pathogens. Clin Microbiol Rev. 2005;18:757–89.10.1128/CMR.18.4.757-789.2005Suche in Google Scholar PubMed PubMed Central

[2] Capoccia R, Greub G, Baud D. Ureaplasma urealyticum, Mycoplasma hominis and adverse pregnancy outcomes. Curr Opin Infect Dis. 2013;26:231–40.10.1097/QCO.0b013e328360db58Suche in Google Scholar PubMed

[3] Kong F, James G, Ma Z, Gordon S, Bin W, Gilbert GL. Phylogenetic analysis of Ureaplasma urealyticum – support for the establishment of a new species, Ureaplasma parvum. Int J Syst Bacteriol. 1999;49:1879–89.10.1099/00207713-49-4-1879Suche in Google Scholar PubMed

[4] Kim CJ, Romero R, Chaemsaithong P, Chaiyasit N, Yoon BH, Kim YM. Acute chorioamnionitis and funisitis: definition, pathologic features, and clinical significance. Am J Obstet Gynecol. 2015;213:S29–52.10.1016/j.ajog.2015.08.040Suche in Google Scholar PubMed PubMed Central

[5] Kim CJ, Romero R, Chaemsaithong P, Kim JS. Chronic inflammation of the placenta: definition, classification, pathogenesis, and clinical significance. Am J Obstet Gynecol. 2015;213:S53–69.10.1016/j.ajog.2015.08.041Suche in Google Scholar PubMed PubMed Central

[6] Kim CJ, Romero R, Kusanovic JP, Yoo W, Dong Z, Topping V, et al. The frequency, clinical significance, and pathological features of chronic chorioamnionitis: a lesion associated with spontaneous preterm birth. Mod Pathol. 2010;23:1000–11.10.1038/modpathol.2010.73Suche in Google Scholar PubMed PubMed Central

[7] Oh KJ, Lee KA, Sohn YK, Park CW, Hong JS, Romero R, et al. Intraamniotic infection with genital mycoplasmas exhibits a more intense inflammatory response than intraamniotic infection with other microorganisms in patients with preterm premature rupture of membranes. Am J Obstet Gynecol. 2010;203:211.e1–8.10.1016/j.ajog.2010.03.035Suche in Google Scholar PubMed PubMed Central

[8] Kim M, Kim G, Romero R, Shim SS, Kim EC, Yoon BH. Biovar diversity of ureaplasma urealyticum in amniotic fluid: distribution, intrauterine inflammatory response and pregnancy outcomes. J Perinat Med. 2003;31:146–52.10.1515/JPM.2003.020Suche in Google Scholar PubMed

[9] Cox C, Saxena N, Watt AP, Gannon C, McKenna JP, Fairley DJ, et al. The common vaginal commensal bacterium Ureaplasma parvum is associated with chorioamnionitis in extreme preterm labour. J Matern Fetal Neonatal Med. 2016;29:3646–51.10.3109/14767058.2016.1140734Suche in Google Scholar PubMed

[10] Viscardi RM. Ureaplasma species: role in neonatal morbidities and outcomes. Arch Dis Child Fetal Neonatal Ed. 2014;99:F87–92.10.1136/archdischild-2012-303351Suche in Google Scholar PubMed PubMed Central

[11] Viscardi RM, Kallapur SG. Role of ureaplasma respiratory tract colonization in bronchopulmonary dysplasia pathogenesis: current concepts and update. Clin Perinatol. 2015;42:719–38.10.1016/j.clp.2015.08.003Suche in Google Scholar PubMed PubMed Central

[12] Pacora P, Chaiworapongsa T, Maymon E, Kim YM, Gomez R, Yoon BH, et al. Funisitis and chorionic vasculitis: the histological counterpart of the fetal inflammatory response syndrome. J Matern Fetal Neonatal Med. 2002;11:18–25.10.1080/jmf.11.1.18.25Suche in Google Scholar PubMed

[13] Redline RW, Faye-Petersen O, Heller D, Qureshi F, Savell V, Vogler C, et al. Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol. 2003;6:435–48.10.1007/s10024-003-7070-ySuche in Google Scholar PubMed

[14] Mizgerd JP. Acute lower respiratory tract infection. N Engl J Med. 2008;358:716–27.10.1056/NEJMra074111Suche in Google Scholar PubMed PubMed Central

[15] Choe HS, Lee DS, Lee SJ, Hong SH, Park DC, Lee MK, et al. Performance of Anyplex™ II multiplex real-time PCR for the diagnosis of seven sexually transmitted infections: comparison with currently available methods. Int J Infect Dis. 2013;17:e1134–40.10.1016/j.ijid.2013.07.011Suche in Google Scholar PubMed

[16] Kim SM, Romero R, Lee J, Chaemsaithong P, Docheva N, Yoon BH. Gastric fluid versus amniotic fluid analysis for the identification of intra-amniotic infection due to Ureaplasma species. J Matern Fetal Neonatal Med. 2016;29:2579–87.Suche in Google Scholar

[17] Romero R, Miranda J, Chaiworapongsa T, Chaemsaithong P, Gotsch F, Dong Z, et al. A novel molecular microbiologic technique for the rapid diagnosis of microbial invasion of the amniotic cavity and intra-amniotic infection in preterm labor with intact membranes. Am J Reprod Immunol. 2014;71:330–58.10.1111/aji.12189Suche in Google Scholar PubMed PubMed Central

[18] Romero R, Miranda J, Kusanovic JP, Chaiworapongsa T, Chaemsaithong P, Martinez A, et al. Clinical chorioamnionitis at term I: microbiology of the amniotic cavity using cultivation and molecular techniques. J Perinat Med. 2015;43:19–36.10.1515/jpm-2014-0249Suche in Google Scholar PubMed PubMed Central

[19] Romero R, Miranda J, Chaemsaithong P, Chaiworapongsa T, Kusanovic JP, Dong Z, et al. Sterile and microbial-associated intra-amniotic inflammation in preterm prelabor rupture of membranes. J Matern Fetal Neonatal Med. 2015;28:1394–409.10.3109/14767058.2014.958463Suche in Google Scholar PubMed PubMed Central

[20] Lee SE, Romero R, Kim EC, Yoon BH. A high Nugent score but not a positive culture for genital mycoplasmas is a risk factor for spontaneous preterm birth. J Matern Fetal Neonatal Med. 2009;22:212–7.10.1080/14767050802616994Suche in Google Scholar PubMed PubMed Central

[21] Romero R, Espinoza J, Gonçalves LF, Kusanovic JP, Friel L, Hassan S. The role of inflammation and infection in preterm birth. Semin Reprod Med. 2007;25:21–39.10.1055/s-2006-956773Suche in Google Scholar PubMed PubMed Central

[22] Nan C, Dangor Z, Cutland CL, Edwards MS, Madhi SA, Cunnington MC. Maternal group B Streptococcus-related stillbirth: a systematic review. Br J Obstet Gynecol. 2015;122:1437–45.10.1111/1471-0528.13527Suche in Google Scholar

[23] Seliga-Siwecka JP, Kornacka MK. Neonatal outcome of preterm infants born to mothers with abnormal genital tract colonisation and chorioamnionitis: a cohort study. Early Hum Dev. 2013;89:271–5.10.1016/j.earlhumdev.2012.10.003Suche in Google Scholar

[24] McDuffie RS Jr, McGregor JA, Gibbs RS. Adverse perinatal outcome and resistant Enterobacteriaceae after antibiotic usage for premature rupture of the membranes and group B streptococcus carriage. Obstet Gynecol. 1993;82:487–9.Suche in Google Scholar

[25] Panero A, Pacifico L, Rossi N, Roggini M, Chiesa C. Ureaplasma urealyticum as a cause of pneumonia in preterm infants: analysis of the white cell response. Arch Dis Child Fetal Neonatal Ed. 1995;73:F37–40.10.1136/fn.73.1.F37Suche in Google Scholar

[26] Lee J, Kim JS, Park JW, Park CW, Park JS, Jun JK, et al. Chronic chorioamnionitis is the most common placental lesion in late preterm birth. Placenta. 2013;34:681–9.10.1016/j.placenta.2013.04.014Suche in Google Scholar

[27] McDonald HM, Chambers HM. Intrauterine infection and spontaneous midgestation abortion: is the spectrum of microorganisms similar to that in preterm labor? Infect Dis Obstet Gynecol. 2000;8:220–7.10.1002/1098-0997(2000)8:5<220::AID-IDOG1022>3.0.CO;2-ISuche in Google Scholar

[28] Seaward PG, Hannah ME, Myhr TL, Farine D, Ohlsson A, Wang EE, et al. International multicentre term prelabor rupture of membranes study: evaluation of predictors of clinical chorioamnionitis and postpartum fever in patients with prelabor rupture of membranes at term. Am J Obstet Gynecol. 1997;177:1024–9.10.1016/S0002-9378(97)70007-3Suche in Google Scholar

Received: 2016-9-15
Accepted: 2017-2-9
Published Online: 2017-5-25
Published in Print: 2018-7-26

©2018 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. A transformative icon for modern perinatology
  4. Highlight: Preterm Labor
  5. Editorial
  6. What’s new in preterm birth prediction and prevention?
  7. Review articles
  8. Pulmo uterinus: a history of ideas on fetal respiration
  9. Mid-trimester preterm premature rupture of membranes (PPROM): etiology, diagnosis, classification, international recommendations of treatment options and outcome
  10. Highlight articles
  11. A soft cervix, categorized by shear-wave elastography, in women with short or with normal cervical length at 18–24 weeks is associated with a higher prevalence of spontaneous preterm delivery
  12. Association between genital mycoplasmas, acute chorioamnionitis and fetal pneumonia in spontaneous abortions
  13. Methylation differences reveal heterogeneity in preterm pathophysiology: results from bipartite network analyses
  14. Understanding fetal factors that contribute to preterm birth: Sjögren-Larsson syndrome as a model
  15. Safety and efficacy of the cervical pessary combined with vaginal progesterone for the prevention of spontaneous preterm birth
  16. Risk of preterm birth by maternal age at first and second pregnancy and race/ethnicity
  17. Infant mortality and causes of death by birth weight for gestational age in non-malformed singleton infants: a 2002–2012 population-based study
  18. Perinatal outcomes after previable preterm premature rupture of membranes before 24 weeks of gestation
  19. Letter to the Editor
  20. Fundal pressure: risk factors in uterine rupture. The issue of liability: complication or malpractice?
Heruntergeladen am 3.12.2025 von https://www.degruyterbrill.com/document/doi/10.1515/jpm-2016-0305/pdf
Button zum nach oben scrollen