Cervical <i>Ureaplasma urealyticum</i> colonization might be associated with increased incidence of preterm delivery in pregnant women without prophlogistic microorganisms on routine examination

Mitsunari, Masahiro; Yoshida, Souichi; Deura, Imari; Horie, Sayako; Tsukihara, Satoru; Harada, Tasuku; Irie, Takashi; Terakawa, Naoki

doi:10.1111/j.1447-0756.2005.00246.x

Cited by 36 publications

(26 citation statements)

References 17 publications

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“…Indeed, Holst et al, demonstrated that the presence of U urealyticum in cervical fluid was associated with higher levels of IL-6in the vaginal fluid [5]. Moreover, recent case-control studies using PCR methods indicated that cervico-vaginal mycoplasma colonization might be associated with preterm birth [16,17]. Investigators suggested that the density of colonization [18] or some specific biovar [19] may be associated with preterm delivery.…”

Section: Discussionmentioning

confidence: 99%

A high Nugent score but not a positive culture for genital mycoplasmas is a risk factor for spontaneous preterm birth

Lee

Romero

Kim

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective This study was performed to evaluate the relationship among the Nugent score for the diagnosis of bacterial vaginosis (BV), the results of vaginal fluid culture for genital mycoplasma, and the subsequent occurrence of preterm birth. Methods The Nugent score and culture for genital mycoplasmas were performed in vaginal fluid obtained from 977 pregnant women (gestational age 13–30 weeks). Vaginal samples were obtained with sterile cotton swabs. The relationship among the Nugent score, vaginal fluid culture results and the occurrence of spontaneous preterm birth was examined. Results (1) Of the 977 women, 14% (137) had a Nugent score of ≥ 8; (2) The prevalence of a positive vaginal culture for genital mycoplasmas was 30% (288); Ureaplasma urealyticum was isolated in 252 (88%), Mycoplasma hominis in 9 (3%), and both in 27 (9%) women; (3) Cases with a Nugent score of ≥ 8 had a higher rate of a positive vaginal culture for genital mycoplasmas than those with the lower Nugent score (55% vs. 25%; p<0.001); (4) Women with a Nugent score of ≥ 8 had a significantly higher rate of spontaneous preterm birth <37 (10% vs. 4%), <34 (5% vs. 2%), and <32 (4% vs. 1%) weeks of gestation than those with the lower Nugent score (At each gestational age, p<0.05); (5) In contrast, a positive vaginal culture for genital mycoplasmas was not associated with an increased risk for spontaneous preterm birth; (6) Among patients with a positive culture and a Nugent score of ≥ 8, the frequency of spontaneous preterm delivery (<37 weeks) was 10% (7/72); (7) There was no difference in the incidence of spontaneous preterm delivery according to the results of vaginal culture in patients with a Nugent score of ≥ 8, as well as in those with a lower Nugent score. Conclusion A high Nugent score (≥ 8) for the detection of BV but not a positive vaginal culture for genital mycoplasmas is a risk factor for spontaneous preterm birth.

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Section: Discussionmentioning

confidence: 99%

A high Nugent score but not a positive culture for genital mycoplasmas is a risk factor for spontaneous preterm birth

Lee

Romero

Kim

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Mitsunari et al [11] findings support the association between cervical U. urealyticum and preterm delivery (controls colonisation 46% compared to 87% in preterm delivery patients).…”

Section: Ureaplasma Sppmentioning

confidence: 78%

“…Ureaplasma genital tract colonization has been associated with adverse pregnancy outcomes such as spontaneous abortion [10], premature rupture of membranes (PROM) [4], premature delivery [11], neonatal morbidity and perinatal death [12]. The methodology and samples vary considerably between studies, which makes combining and synthesizing the result difficult.…”

Section: Ureaplasma Sppmentioning

confidence: 99%

Urogenital Mycoplasmosis and Pregnancy

Põder¹,

Haldre²

2016

J Antimicrob Agents

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Urogenital mycoplasmas Ureaplasma urealyticum, Ureaplasma parvum and Mycoplasma hominis have long been considered commensals of human urogenital microflora. Several studies have recently clarified whether these bacteria could cause or be associated with various obstetric complications. Epidemiologic studies have found high prevalence of Ureaplasma spp. and M. hominis among otherwise healthy population. On the other hand, U. urealyticum, U. parvum and M. hominis have increasingly been linked to adverse pregnancy outcomes such as spontaneous pre-term labor, pre-term premature rupture of fetal membranes, miscarriage, stillbirth and low birth weight. However, no convincing causal relationship has been shown. Studies have shown that antibiotics resistance is on the rise and differs considerably by regions. Screening of asymptomatic patients for M. hominis, U. urealyticum and U. parvum is currently still not indicated.

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“…in amniotic fluid was associated neither with a different pregnancy outcome nor with the magnitude of the intraamniotic inflammatory response (7). Mitsunary et al showed that the difference between biovars in the cervix did not influence the evidence of preterm labor (10). A high density vaginal colonization with Uu.…”

Section: Discussionmentioning

confidence: 99%

Preterm Premature Rupture of the Membranes and Genital Mycoplasmas

Kacerovský

Pavlovský²,

Tošner

2009

Acta Med. (Hradec Kralove, Czech Repub.)

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Preterm delivery is one of the main causes of perinatal mortality and morbidity worldwide. It is an escalating problem in Czech Republic and has increased to 6 %. Premature rupture of the membranes is defined as fetal membranes rupture with leakage of amniotic fluid that precedes the onset of uterine contraction by at least 2 hours. It complicates 4-7 % of all births and is directly associated with a short length of gestation and an increased perinatal morbidity and mortality. There are predisposing conditions connected with the occurrence of premature rupture of the membranes such as local infections, cervical incompetence and low socio-economic condition (5, 13). Even so, the aetiology still remains unknown in the majority of cases. Increased biosynthesis of prostaglandins by intrauterine tissue is widely accepted as a key event in the initiation of parturition (8). Preterm labour after spontaneous rupture of the membranes is associated with a significant increase in amniotic fluid concentration of prostaglandins. A main reason of this elevation is probably infection. The purpose of this study was to evaluate the prevalence of cervical colonization by genital mycoplasmas (Ureaplasma urealyticum and/or Mycoplasma hominis) in patients with preterm premature rupture of the membranes (PPROM). The cervical detection rates of genital mycoplasmas were compared with a normal population of pregnant women in the Czech Republic. Patients and method Study populationThe study population involved 225 pregnant women with PPROM (gestation age between 24 and 36 weeks) who were admitted to the department of Obstetrics and Gynaecology in Most from January 2004 to February 2007. There were no differences in the demographic data of the groups studied and all groups were similar with regard to parity and gravidity. Their age at the time of diagnosis ranged from 19 to 38 years (median age 26). Women with multiple gestation or major fetal anomaly were excluded from the study. Written consent was obtained from each patient. Rupture of membranes was diagnosed by an examination with a sterile speculum and a combination of vaginal pooling of amniotic fluid and the nitrazine test or a positive result for insulin-like growth factor binding protein -1 (PROM test) in the vaginal fluid. Cervical swabs were obtained for detecting genital mycoplasmas and standard vaginal smears of bacterial culture were performed at the time of their admission. Sample of maternal blood was obtained for investigation of maternal CRP level. The control group comprised 225 otherwise healthy women in the mid trimester of pregnancy (gestation age between 24-28 weeks) from whom we obtained cervical swabs for genital mycoplasmas during routine prenatal examination. All these women delivered between 38th and 41st week of gestation without ad- Summary: Objective: The purpose of this study was to evaluate the prevalence of cervical colonization by genital mycoplasmas in patients with preterm premature rupture of the membranes (PPROM). Method: We studied 225 women between...

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Cervical Ureaplasma urealyticum colonization might be associated with increased incidence of preterm delivery in pregnant women without prophlogistic microorganisms on routine examination

Abstract: Cervical U. urealyticum colonization might be associated with preterm labor and delivery.

Cited by 36 publications

References 17 publications

A high Nugent score but not a positive culture for genital mycoplasmas is a risk factor for spontaneous preterm birth

A high Nugent score but not a positive culture for genital mycoplasmas is a risk factor for spontaneous preterm birth

Urogenital Mycoplasmosis and Pregnancy

Preterm Premature Rupture of the Membranes and Genital Mycoplasmas

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