Maternal Genital Colonization with Ureaplasma urealyticum Promotes Preterm Delivery: Association of the Respiratory Colonization of Premature Infants with Chronic Lung Disease and Increased Mortality

Background. Infection of the chorioamnion with Ureaplasma urealyticum has been associated with low birth weight. Respiratory tract colonization in preterm infants has been associated with the development of chronic lung disease (CLD). The purpose of the present study was to determine the frequency o...

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Published in:	Clinical infectious diseases Vol. 39; no. 8; pp. 1113 - 1122
Main Authors:	Kafetzis, Dimitris A., Skevaki, Chrysanthi L., Skouteri, Vassiliki, Gavrili, Stavroula, Peppa, Katerina, Kostalos, Christos, Petrochilou, Vassiliki, Michalas, Stellios
Format:	Journal Article
Language:	English
Published:	Chicago, IL The University of Chicago Press 15-10-2004 University of Chicago Press
Subjects:	Adult Biological and medical sciences Birth Weight Chronic Disease Delivery. Postpartum. Lactation Diseases of mother, fetus and pregnancy Female Gestational age Gynecology. Andrology. Obstetrics Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases - microbiology Infant, Premature, Diseases - mortality Infants Infections Infectious Disease Transmission, Vertical Low birth weight Lung diseases Lung Diseases - microbiology Lung Diseases - mortality Major Articles Male Medical sciences Oxygen Pregnancy Pregnancy. Fetus. Placenta Premature Birth - etiology Premature Birth - microbiology Prospective Studies Risk Factors Ureaplasma Ureaplasma Infections - microbiology Ureaplasma Infections - physiopathology Ureaplasma urealyticum Ureaplasma urealyticum - isolation & purification Vagina - microbiology Premature Prognosis Pregnancy disorders Infant Maternal diseases Birth Mollicutes Respiratory tract Mycoplasmatales Ureaplasma urealyticum Bacteria Human Lung disease Respiratory disease Secretion Mortality Genital system Low birth weight Vagina Hospitalization Method Mycoplasmataceae Newborn diseases Chronic Newborn Prematurity Delivery Colonization
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Summary:	Background. Infection of the chorioamnion with Ureaplasma urealyticum has been associated with low birth weight. Respiratory tract colonization in preterm infants has been associated with the development of chronic lung disease (CLD). The purpose of the present study was to determine the frequency of colonization of the mother's vagina and the preterm infant's respiratory tract and to associate U. urealyticum with premature birth and with development of CLD in the newborn. Methods. The present prospective study involved 126 mothers with preterm delivery and 125 mothers with full-term delivery, as well as their offspring. Vaginal secretion specimens were obtained from each mother before delivery. Rhinopharyngeal secretion or tracheal lavage specimens were collected after the birth of each premature and full-term infant and then periodically during hospitalization. Results. Vaginal Ureaplasma colonization occurred among 36.5% of mothers with preterm delivery and among 38% of mothers with full-term delivery. The rate of vertical transmission was 33% and 17% for mothers with preterm delivery and mothers with full-term delivery, respectively. The transmission rate for infants, according to birth weight, was as follows: 60%, for infants with a birth weight of <1000 g; 50%, for infants with a birth weight of 1000–1500 g; and 15.3%, for infants with a birth weight of ⩾1500 g (P = .001). The median gestational age of preterm infants born to colonized mothers was 28.5 weeks, and that of preterm infants born to noncolonized mothers was 32 weeks (P < .0001). The median birth weight of colonized preterm infants was 1135 g, and that of noncolonized infants was 1670 g (P < .0001). Twenty-four percent of preterm infants and 10% of full-term infants were colonized with U. urealyticum. Of colonized preterm infants, 27% developed CLD, compared with 9% of noncolonized infants (P = .03). Mortality was significantly higher among colonized preterm infants (P = .003). Conclusions. The rate of vertical transmission is highest among preterm infants with a birth weight of <1500 g. Vaginal colonization with Ureaplasma organisms is associated with premature delivery. Colonization of the respiratory tract of infants is associated with the development of CLD and with increased mortality.
Bibliography:	ark:/67375/HXZ-HV664SLK-R istex:09225E089DAF4DB52CB88586E39D781819800941 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	1058-4838 1537-6591
DOI:	10.1086/424505