Association of abnormal vaginal flora and Ureaplasma species as risk factors for preterm birth: a cohort study

Breugelmans, Maria; Vancutsem, Ellen; Naessens, Anne; Laubach, Monika; Foulon, Walter

doi:10.3109/00016340903418769

Cited by 63 publications

(51 citation statements)

References 35 publications

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“…- which can be noninvasively screened for - and both preterm delivery and morbidity of the preterm infant reported conflicting results [4,10,11,12,13]. The reason why these microorganisms sometimes cause ascending infections while leading to no clinical symptoms in most cases is not yet understood.…”

Section: Introductionmentioning

confidence: 99%

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First Trimester Vaginal Ureaplasma Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

Rittenschober-Böhm¹,

Waldhoer²,

Schulz³

et al. 2017

Neonatology

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Background: While there is a proven association of upper genital tract Ureaplasma infection during pregnancy with adverse pregnancy outcome, the effect of vaginal Ureaplasma colonization on preterm delivery has been controversially debated. Objectives: We hypothesized that women with isolation of vaginal U. parvum but not U. urealyticum are at increased risk for spontaneous preterm birth (SPB) compared to women with negative results. Methods: A vaginal swab taken between 12 and 14 weeks of gestation was analyzed for the presence of Ureaplasma biovars by PCR in 4,330 pregnant women. Results: Of the study cohort, 37% were positive for U. parvum, 5.9% for U. urealyticum, and 3.1% for both. The rates of SPB were 10.4% (OR 1.7, 95% CI 1.3, 2.2, p < 0.001) and 8.9% (OR 1.4, 95% CI 0.9, 2.3, p = 0.193) in the groups with isolation of U. parvum and U. urealyticum, respectively, compared to 6.4% in the group with negative PCR results. Multiple logistic regression and interaction analyses showed that vaginal colonization with U. parvum but not U. urealyticum was a statistically significant risk factor for SPB (adjusted OR 1.6, 95% CI 1.2, 2.1, p < 0.001), independent of other risk factors such as bacterial vaginosis and history of SPB. Conclusion: Our study demonstrates a statistically significant and independent association between first-trimester vaginal colonization with U. parvum and subsequent SPB.

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Section: Introductionmentioning

confidence: 99%

“…[2,3]. However, since these potentially pathogenic bacteria are also present in 40-80% of asymptomatic sexually active women [3,4], it is still not clear what role if any they might have in inducing PL when found in the vaginal tract during pregnancy. Although Ureaplasma spp.…”

Section: Introductionmentioning

confidence: 99%

First Trimester Vaginal Ureaplasma Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

Rittenschober-Böhm¹,

Waldhoer²,

Schulz³

et al. 2017

Neonatology

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“…The isolation of Ureaplasma spp. from the placenta or the lower genital tract in pregnancy is associated with both intrauterine inflammation and PTB (5,6). Thus, Ureaplasma spp.…”

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confidence: 99%

Maternal Intravenous Treatment with either Azithromycin or Solithromycin Clears Ureaplasma parvum from the Amniotic Fluid in an Ovine Model of Intrauterine Infection

Miura

Payne

Keelan

et al. 2014

Antimicrob Agents Chemother

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“…However, in some cases, Ureaplasma species have interfered with normal fetal development by causing an ascending infection. [2][3][4][5][6][7] The reason for this infection is not fully understood but may be associated with the virulence of the microorganism, the host immune system, or local factors present in the lower genital tract. Species differentiation might be important because previous studies 2,8,9 suggest that nongonococcal urethritis and an adverse pregnancy outcome with respect to birth weight, gestational age, and preterm delivery are implicated with the presence of U. urealyticum and not with U. parvum.…”

mentioning

confidence: 99%

Modified Real-Time PCR for Detecting, Differentiating, and Quantifying Ureaplasma urealyticum and Ureaplasma parvum

Vancutsem

Soetens

Breugelmans

et al. 2011

The Journal of Molecular Diagnostics

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We evaluated a previously described quantitative realtime PCR (qPCR) for quantifying and differentiating Ureaplasma parvum and U. urealyticum. Because of nonspecific reactions with Staphylococcus aureus DNA in the U. parvum PCR, we developed a modified qPCR and designed new primers. These oligonucleotides eradicated cross-reactions, indicating higher specificity. The detection limits of the qPCR were determined at 1 and 3 colony-forming units/ml for U. parvum and U. urealyticum, respectively. The quantification limits of the assay for both Ureaplasma species ranged from 2.10 6 to 2.10 1 copy numbers per PCR. A total of 300 patient samples obtained from the lower genital tract were tested with this newly designed qPCR assay and compared with culture results. Of the samples, 132 (44.0%) were culture positive, whereas 151 (50.3%) tested positive using qPCR. The U. parvum and U. urealyticum species were present in 79.5% and 12.6% of the qPCR-positive samples, respectively. Both species were found in 7.9% of those samples. Quantification of U. parvum and U. urealyticum in the samples ranged from less than 2.5 ؋ 10 3 to 7.4 ؋ 10 7 copies per specimen. In conclusion, the modified qPCR is a suitable method for rapid detection, differentiation, and quantification of U. parvum and U. urealyticum.

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Association of abnormal vaginal flora and Ureaplasma species as risk factors for preterm birth: a cohort study

Abstract: Preterm delivery was significantly correlated with the presence of U. spp. The risk for preterm delivery increased when U. spp. was associated with an abnormal vaginal flora.

Cited by 63 publications

References 35 publications

First Trimester Vaginal <b><i>Ureaplasma</i></b> Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

First Trimester Vaginal <b><i>Ureaplasma</i></b> Biovar Colonization and Preterm Birth: Results of a Prospective Multicenter Study

Maternal Intravenous Treatment with either Azithromycin or Solithromycin Clears Ureaplasma parvum from the Amniotic Fluid in an Ovine Model of Intrauterine Infection

Modified Real-Time PCR for Detecting, Differentiating, and Quantifying Ureaplasma urealyticum and Ureaplasma parvum

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