Intrauterine infection with Ureaplasma species is associated with adverse neuromotor outcome at 1 and 2 years adjusted age in preterm infants

Berger, Angelika; Witt, Armin; Haiden, Nadja; Kaider, Alexandra; Klebermasz, Katrin; Fuiko, Renate; Langgartner, Michaela; Pollak, Arnold

doi:10.1515/jpm.2009.016

Cited by 66 publications

(44 citation statements)

References 22 publications

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“…2 At 2 years of age, infants born <33 weeks gestation who were exposed to intrauterine ureaplasma infection had higher rate of cerebral palsy and lower psychomotor development index scores on the Bayley Scales of Infant Development at 2 years adjusted age compared with non-exposed infants. 12 Studies of potential therapeutic interventions for perinatal ureaplasma exposure will need to include long-term pulmonary and neurodevelopmental assessments.…”

Section: Long-term Outcomes Of Perinatal Ureaplasma Exposurementioning

confidence: 99%

Ureaplasmaspecies: role in neonatal morbidities and outcomes

Viscardi

2013

Arch Dis Child Fetal Neonatal Ed

125

100

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The genital mycoplasma species, Ureaplasma parvum and U. urealyticum are the most common organisms isolated from infected amniotic fluid and placentas and they contribute to adverse pregnancy outcomes including preterm birth and neonatal morbidities. In our institution, almost half of preterm infants less than 32 weeks gestation are Ureaplasma-positive in one or more compartment (respiratory, blood, and/or cerebrospinal fluid), indicating that these organisms are the most common pathogens affecting this population. This review will focus on the compelling epidemiologic and experimental evidence linking perinatal Ureaplasma species exposure to important morbidities of prematurity such as bronchopulmonary dysplasia, intraventricular hemorrhage, and necrotizing enterocolitis.

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Section: Long-term Outcomes Of Perinatal Ureaplasma Exposurementioning

confidence: 99%

Ureaplasmaspecies: role in neonatal morbidities and outcomes

Viscardi

2013

Arch Dis Child Fetal Neonatal Ed

125

100

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“…Ureaplasma infection induces production of tumor necrosis factor-α and interleukin-6 [11] and also causes apoptosis of human type 2 lung epithelial cells and lung macrophages [12]. Apart from BPD, Ureaplasma has also been associated with retinopathy of prematurity [13], intraventricular hemorrhage [14,15], necrotizing enterocolitis (NEC) [16] and adverse neurodevelopmental outcome [17]; all these associations could be attributed to the ability of Ureaplasma to elicit an inflammatory reaction.…”

Section: Introductionmentioning

confidence: 99%

Azithromycin and Other Macrolides for Prevention of Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

2014

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Background and Objective:Ureaplasma spp. infection has been associated with bronchopulmonary dysplasia (BPD) in preterm infants. Macrolides have been used for the treatment of Ureaplasma spp. infection, with an intention to prevent BPD. The objective of this meta-analysis is to evaluate the use of macrolides in the prevention of BPD in preterm infants. Methods: We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials, abstracts of the major pediatric society meetings and bibliographies of retrieved articles. We included randomized controlled trials assessing the effects of macrolides therapy on BPD in preterm infants. A random/fixed-effect model was used to synthesize predefined outcomes. Results: Six studies involving 469 preterm infants were eligible for the analysis. Macrolides when used prophylactically (4 studies) did not show significant reduction in BPD (risk ratio, RR, 0.88, 95% confidence interval, CI, 0.75-1.03), death (RR 0.89, 95% CI 0.79-1.01) or in the composite outcome of BPD/death. Similarly, there was no significant reduction in BPD (RR 0.64, 95% CI 0.31-1.31) or the composite outcome of BPD/death (RR 0.41, 95% CI 0.05-3.13), when macrolides were used in Ureaplasma-positive infants. However, prophylactic azithromycin therapy (3 studies) was associated with significant reduction in BPD (RR 0.83, 95% CI 0.71-0.97; number needed to treat, NNT, 10) and composite outcome of BPD/death (RR 0.86, 95% CI 0.77-0.97; NNT 10). Conclusion: This meta-analysis demonstrates prophylactic azithromycin therapy was associated with statistically significant reduction in BPD and the composite outcome of BPD/death in preterm infants. However, given the limited information on pharmacokinetics and potential harmful effects, further studies should be done before routine use of azithromycin in the neonatal population.

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“…Furthermore, U. urealyticum has more often been related to preterm delivery and neuromotor outcome than other bacteria [5]. Viscardi et al has recently provided evidence that invasive Ureaplasma infection occurs commonly in very low birth weight infants and may increase the risk for severe intraventricular hemorrhage [6].…”

Section: Introductionmentioning

confidence: 99%

Interleukin-6 andMycoplasma hominisas markers of preterm birth and related brain damage: Our experience

Massaro

Scaravilli

Simeone³

et al. 2009

The Journal of Maternal-Fetal & Neonatal Medicine

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In order to achieve a good therapeutic purpose and get to an efficient strategy, the patients have to be elected by a number of criteria, which may include anamnesis elements, vaginal swab, then cytokines dosage in selected women, thus excluding the low-risk cases. Further studies are expected in order to plan guidelines including the dosage of ILs and principally of IL-6 as a main marker of preterm birth, above all during the second trimester.

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Intrauterine infection with Ureaplasma species is associated with adverse neuromotor outcome at 1 and 2 years adjusted age in preterm infants

Abstract: Isolation of pathogens from the amniotic cavity at birth is significantly associated with abnormal PDI and adverse neuromotor outcome in preterm infants, irrespective of gestational age and birthweight.

Cited by 66 publications

References 22 publications

Ureaplasmaspecies: role in neonatal morbidities and outcomes

Ureaplasmaspecies: role in neonatal morbidities and outcomes

Azithromycin and Other Macrolides for Prevention of Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Interleukin-6 andMycoplasma hominisas markers of preterm birth and related brain damage: Our experience

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