Maternal Infection and Preterm Birth: From Molecular Basis to Clinical Implications

Daskalakis, Georgios; Psarris, Alexandros; Koutras, Antonios; Fasoulakis, Zacharias; Prokopakis, Ioannis; Varthaliti, Antonia; Karasmani, Christina; Ntounis, Thomas; Domali, E.; Theodora, Marianna; Antsaklis, Panagiotis; Pappa, Kalliopi I.; Papapanagiotou, Angeliki

doi:10.3390/children10050907

Cited by 20 publications

(16 citation statements)

References 140 publications

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“…This aspect was not explored in our study, suggesting that the interplay between medical and social factors in the context of PTB is complex and multifaceted. These differences highlight the importance of a comprehensive approach to PTB management, considering both the clinical treatment of infections and broader sociodemographic influences [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of Genital Infections and Antibiotic Use on Incidence of Preterm Birth: A Retrospective Observational Study

Marti,

Bratosin,

Rosca

et al. 2024

Antibiotics

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This study investigates the complex interplay among genital infections, antibiotic usage, and preterm birth. This study aims to identify common genital pathogens associated with preterm births, assess the impact of various antibiotic treatments on pregnancy outcomes, and understand antibiotic resistance patterns among these pathogens. This study included 71 pregnant women who experienced preterm birth and 94 women with genital infections who delivered at term. Various maternal characteristics, medical history, signs and symptoms, gestational weight, gestational age, type of birth, vaginal pH, Nugent scores, and vaginal flora were analyzed. Antibiotic resistance patterns of isolated microorganisms were also examined. The prevalence of sexually transmitted diseases (STDs) and genital herpes was significantly higher in the preterm group. Preterm births were associated with fever, pelvic pain, vaginal spotting, and fatigue. Vaginal pH levels and Nugent scores were significantly higher in the preterm group, indicating disturbed vaginal flora. The presence of Extended-Spectrum Beta-Lactamases (ESBLs) was a particularly strong risk factor, increasing by more than four times the odds of preterm birth (OR = 4.45, p = 0.001). Vancomycin-Resistant Enterococci (VRE) presence was another critical factor, with a four-fold increase in the odds of preterm birth (OR = 4.01, p = 0.034). The overall presence of Multidrug-Resistant (MDR) organisms significantly increased the odds of preterm birth (OR = 3.73, p = 0.001). Specific pathogens like Chlamydia trachomatis (OR = 3.12, p = 0.020) and Mycoplasma hominis (OR = 3.64, p = 0.006) were also identified as significant risk factors. Ureaplasma urealyticum also showed a significantly higher risk of preterm birth (OR = 2.76, p = 0.009). This study highlights the importance of screening for and treating genital infections during pregnancy, especially STDs and genital herpes, as they can significantly increase the risk of preterm birth. Additionally, the presence of specific microorganisms and antibiotic resistance patterns plays an essential role in preterm birth risk. Early detection and targeted antibiotic treatment may help mitigate this risk and improve pregnancy outcomes.

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Section: Discussionmentioning

confidence: 99%

“…In the review by Daskalakis et al [ 36 ], several key similarities and differences in the understanding of the role of infections in preterm births emerged. Both their study and ours recognized the significant impact of infections on preterm birth, but the subject was approached from different perspectives.…”

Section: Discussionmentioning

confidence: 99%

Impact of Genital Infections and Antibiotic Use on Incidence of Preterm Birth: A Retrospective Observational Study

Marti,

Bratosin,

Rosca

et al. 2024

Antibiotics

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“…Preterm delivery, neonatal sepsis, intrauterine growth retardation, and intrauterine fetal death are the fetal problems associated with PPROM. Placental abruption, postpartum hemorrhage, and chorio-decidual infection are associated with maternal complications [ 7 , 8 ]. Maternal anemia is hypothesized to cause PPROM by weakening the immune system and making the body more susceptible to infections, while the precise process is unknown [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Frequency of Maternal Anemia in Patients Presenting With Preterm Premature Rupture of Membranes

Khan,

Khattak

2024

Cureus

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Background: Preterm premature rupture of membranes (PPROM) is the rupture of fetal membranes before 38 weeks of gestation. The etiology is multifactorial. Maternal anemia is one of the factors leading to PPROM. This study aims to determine the frequency of maternal anemia in patients presenting with PPROM. Materials and Methods: This cross-sectional study was carried out at the Department of Obstetrics and Gynecology, Lady Reading Hospital, Peshawar. This study was conducted from July 1 to December 31, 2021. One hundred and twenty two patients with PPROM presenting to the Department of Obstetrics and Gynecology were included. The diagnosis of PPROM was made based on the history of the PV leak, followed by confirmation with the nitrazine litmus test, microscopic fern test, and ultrasonographic amniotic fluid index measurement. Anemia was determined by examination of hemoglobin levels in the maternal blood samples. Hb <11gm/dl was labeled as anemia. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. was used for statistical analysis. Results: The age of the patients ranged from 20 to 40 years. The mean age was 29.14 ± 6.194 years. 63 patients (51.6%) were multiparous (parity 2 to 4). Maternal anemia was observed in 39 patients (32.0%). A significant association (p = 0.005) was observed between maternal anemia and grand multiparity (parity 2 to 4). Conclusion: Maternal anemia significantly contributes to PPROM, especially in multiple pregnancies. Meticulous family planning and consistent obstetrical monitoring throughout pregnancy are key to addressing this, potentially reducing both maternal anemia risk and PPROM complications.

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“…2 According to growing evidences, intrauterine infection is one of the crucial factor in the pathogenesis of spontaneous preterm delivery. 3,4 Although a number of pathogens such as Chlamydia trachomatis, Group B streptococci, Ureaplasma urealyticum, Mycoplasma hominis, Trichomonas vaginalis and bacterial vaginosis have all been found associated with one or more adverse pregnancy outcomes, [5][6][7][8] but the most commonly associated organisms with premature birth are Chlamydia trachomatis and genital mycoplasmas (Ureaplasma urealyticum and Mycoplasma hominis). [9][10][11] The primary risk factor for spontaneous PTB (sPTB) is infection and infection-driven activation of inflammatory responses.…”

Section: Introductionmentioning

confidence: 99%

Intronic variants of LGALS13 gene encoding placental protein (PP13) are linked with increased risk of infection‐associated spontaneous preterm birth

Bhati

Ray

Arora

et al. 2023

American J Rep Immunol

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ProblemSpontaneous preterm birth (sPTB) is a global health issue. Studies suggest infection and infection‐based inflammatory responses are major risk factors for sPTB. Considering the important role of anti‐inflammatory proteins in pregnancy, the study aimed to find the association between anti‐inflammatory LGALS13 gene variants IVS2‐22 A/G (rs2233706) and IVS3+72 T/A (rs2233708) and the risk of sPTB during Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum infection in Indian population.Method of studyPlacental samples of 160 sPTB and 160 term women were collected. Pathogens were detected by PCR. The genotyping of LGALS13 gene variants IVS2‐22 A/G (rs2233706) and IVS3+72 T/A (rs2233708) was done by qualitative real‐time PCR using allelic discrimination method (VIC‐ and FAM‐labeled).ResultsThe frequency of AG or GG genotype of LGALS13 IVS2‐22A/G polymorphism (rs2233706) was 75.5% in infected sPTB cases and 14.4% in uninfected sPTB cases and 7.3% in term birth controls (p < .0001), while the frequency of TA or AA genotype of LGALS13 IVS3+72T/A polymorphism (rs2233708) was 83.6% in infected sPTB cases and 18% in uninfected sPTB cases and 12.7% in term birth controls (p < .0001). The genotypic frequencies for both the variants of LGALS13 were statistically significant (p < .0001) in the infected sPTB versus uninfected sPTB and term birth controls.ConclusionsStudy reveals strong association between the presence of immunological gene variants LGALS13 IVS2‐22 A/G (rs2233706) and LGALS13 IVS3+72 T/A (rs2233708) and risk of sPTB during C. trachomatis, M. hominis and U. urealyticum infection.

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Maternal Infection and Preterm Birth: From Molecular Basis to Clinical Implications

Cited by 20 publications

References 140 publications

Impact of Genital Infections and Antibiotic Use on Incidence of Preterm Birth: A Retrospective Observational Study

Impact of Genital Infections and Antibiotic Use on Incidence of Preterm Birth: A Retrospective Observational Study

Frequency of Maternal Anemia in Patients Presenting With Preterm Premature Rupture of Membranes

Intronic variants of LGALS13 gene encoding placental protein (PP13) are linked with increased risk of infection‐associated spontaneous preterm birth

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