Document Detail


The Alabama Preterm Birth Study: umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis cultures in very preterm newborn infants.
MedLine Citation:
PMID:  18166302     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study was undertaken to evaluate the frequency of umbilical cord blood infections with Ureaplasma urealyticum and Mycoplasma hominis in preterm 23- to 32-week births and to determine their association with various obstetric conditions, markers of placental inflammation, and newborn outcomes.
STUDY DESIGN: 351 mother/infant dyads with deliveries between 23 and 32 weeks' gestational age who had cord blood cultures for U. urealyticum and M. hominis had their medical records abstracted, other placental cultures performed, cord interleukin-6 levels determined, placentas evaluated histologically, and infant outcomes determined.
RESULTS: U. urealyticum and/or M. hominis were present in 23% of cord blood cultures. Positive cultures were more common in infants of nonwhite women (27.9% vs 16.8%; P = .016), in women less than 20 years of age, in those undergoing a spontaneous compared to an indicated preterm delivery (34.7% vs 3.2%; P = .0001), and in those delivering at earlier gestational ages. Intrauterine infection and inflammation were more common among infants with a positive U. urealyticum and M. hominis culture as evidenced by placental cultures for these and other bacteria, elevated cord blood interleukin-6 levels, and placental histology. Infants with positive cord blood U. urealyticum and M. hominis cultures were more likely to have neonatal systemic inflammatory response syndrome (41.3% vs 25.7%; P = .007; adjusted odds ratio, 1.86; 1.08-3.21) and probably bronchopulmonary dysplasia (26.8% vs 10.1%; P = .0001; adjusted odds ratio 1.99; 0.91-4.37), but were not significantly different for other neonatal outcomes, including respiratory distress syndrome, intraventricular hemorrhage, or death.
CONCLUSION: U. urealyticum and M. hominis cord blood infections are far more common in spontaneous vs indicated preterm deliveries and are strongly associated with markers of acute placental inflammation. Positive cultures are associated with neonatal systemic inflammatory response syndrome and probably bronchopulmonary dysplasia.
Authors:
Robert L Goldenberg; William W Andrews; Alice R Goepfert; Ona Faye-Petersen; Suzanne P Cliver; Waldemar A Carlo; John C Hauth
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  198     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-01     Completed Date:  2008-01-28     Revised Date:  2013-10-28    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43.e1-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Alabama / epidemiology
Cohort Studies
Colony Count, Microbial
Female
Fetal Blood / microbiology*
Follow-Up Studies
Gestational Age
Humans
Incidence
Infant, Newborn
Infant, Very Low Birth Weight*
Mycoplasma Infections / diagnosis,  epidemiology
Mycoplasma hominis / isolation & purification*
Pregnancy
Pregnancy Complications, Infectious / epidemiology,  microbiology*
Pregnancy Outcome
Premature Birth*
Probability
Risk Assessment
Ureaplasma Infections / diagnosis,  epidemiology
Ureaplasma urealyticum / isolation & purification*
Grant Support
ID/Acronym/Agency:
HD 33927/HD/NICHD NIH HHS; P01 HD033927/HD/NICHD NIH HHS; P01 HD033927-050002/HD/NICHD NIH HHS
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 2008 Jan;198(1):1-3   [PMID:  18166295 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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