Prenatal microbiological risk factors associated with preterm birth

McDonald, Helen; O'Loughlin, Jennifer; Jolley, P. T.; Vigneswaran, R.; McDonald, P.

doi:10.1016/0020-7292(92)90297-v

Cited by 29 publications

(44 citation statements)

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“…Gestational ages were equivalent (68 to 70%), and lung development at this time in gestation is similar. It is possible that events leading to human premature birth, specifically the high incidence of chorioamniotic infection with fetal inflammatory response, could alter the subsequent pulmonary cytokine response of the human premature as compared with that of premature baboons delivered by elective hysterotomy (54)(55)(56)(57). The significant differences in pulmonary mechanics present throughout the course of this study suggest that the histologic differences between HFOV and LV-PPV animals could be related to differences in how these two techniques maintain lung inflation.…”

Section: Time-dependent Changes For Tracheal Cytokines In Immature Bamentioning

confidence: 89%

High-frequency Oscillatory Ventilation

Yoder

Siler-Khodr

Winter

et al. 2000

Am J Respir Crit Care Med

161

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Acute lung injury models demonstrate that high-frequency oscillatory ventilation (HFOV) improves lung function, mechanics, and histopathology with reduced inflammatory mediators. Neither human HFOV trials nor premature animal studies have adequately evaluated these factors during prolonged HFOV. The objective of this study was to compare the effect of prolonged HFOV with low tidal volume (VT) positive pressure ventilation (LV-PPV) in an immature baboon model for neonatal chronic lung disease (CLD). After administration of prenatal steroids, 18 baboons were delivered by cesarean section at 125 d (term = 185 d), treated with exogenous surfactant, then randomized to either HFOV or LV-PPV by 5 min age. Animals were maintained on oxygen on an "as needed" basis and on nutritional support for 1 to 2 mo. Serial pulmonary function testing (PFT) was performed. Tracheal aspirates were analyzed for interleukin-6 (IL-6), IL-8, tumor necrosis factor-alpha (TNF-alpha), IL-1beta, and IL-10. Lungs were inflation fixed for morphometric analyses. From 12 h through 10 d age, HFOV animals had consistently lower fraction of inspired oxygen (FI(O(2))) and higher a/ A ratio. Pulmonary mechanics were significantly improved in HFOV animals at nearly every time point analyzed from 12 h to 28 d. There were no consistent differences in tracheal IL-6, TNF-alpha, IL-1beta, or IL-10 after 24 h age. Higher tracheal IL-8 values and macrophage/monocyte numbers were found in LV-PPV animals after 1 wk and 3 to 4 wk ventilation. Both groups exhibited pulmonary pathologic lesions found in extremely immature humans, including alveolar hypoplasia, variable saccular wall fibrosis, and minimal airway disease. HFOV animals had significantly better lung inflation patterns by panel of standards analysis. Early, prolonged HFOV significantly improved early lung function with sustained improvement in pulmonary mechanics out to 28 d. Immature baboons managed with HFOV had less pulmonary inflammation in the hyaline membrane disease (HMD) recovery phase. Though enhanced alveolization was not observed, HFOV for 1 to 2 mo resulted in consistently more uniform lung inflation than LV-PPV.

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Section: Time-dependent Changes For Tracheal Cytokines In Immature Bamentioning

confidence: 89%

High-frequency Oscillatory Ventilation

Yoder

Siler-Khodr

Winter

et al. 2000

Am J Respir Crit Care Med

161

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“…In a cross-sectional study of reproductive age women in 2001 the National Health and Nutrition Examination Survey (NHANES) found that the prevalence of BV in the U.S. was 29.2% (59). BV has been shown to be an independent risk factor for the acquisition of sexually transmitted infections (19; 69; 83; 118), the acquisition and transmission of HIV (20–22; 69; 103; 105), the development of pelvic inflammatory disease (PID) (76), as well as reproductive tract and obstetric sequelae (37; 39; 49; 71; 72). Numerous investigations have been performed to identify factors that increase a woman’s risk to BV.…”

Section: Bacterial Vaginosismentioning

confidence: 99%

Vaginal Microbiome: Rethinking Health and Disease

Forney

Ravel

2012

Annu. Rev. Microbiol.

598

484

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Vaginal microbiota form a mutually beneficial relationship with their host and have a major impact on health and disease. In recent years our understanding of vaginal bacterial community composition and structure has significantly broadened as a result of investigators using cultivation-independent methods based on the analysis of 16S ribosomal RNA (rRNA) gene sequences. In asymptomatic, otherwise healthy women, several kinds of vaginal microbiota exist, the majority often dominated by species of Lactobacillus, while others are composed of a diverse array of anaerobic microorganisms. Bacterial vaginosis is the most common vaginal condition and is vaguely characterized as the disruption of the equilibrium of the normal vaginal microbiota. A better understanding of normal and healthy vaginal ecosystems that is based on their true function and not simply on their composition would help better define health and further improve disease diagnostics as well as the development of more personalized regimens to promote health and treat diseases.

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“…In a study of 534 pregnant women, cervical infection with Chlamydia trachomatis BV was independently associated with PPROM, SPTL and LBW (Gravett et al 1986). Th e presence of Gardnerella vaginalis and Ureaplasma urealyticum during the 2nd trimester increased the risk of PTB two-fold (McDonald et al 1992). …”

Section: Can Abnormal Genital Tract Colonisation Identify Women At Rimentioning

confidence: 96%

“…Th e main cohort studies from Europe, North America and the Far East (Gravett et al 1986;Kurki et al 1992;Riduan et al 1993;Hay et al 1994;McGregor et al 1994;Hillier et al 1995;Meis et al 1995;Gratacos et al 1998) and three case -control studies from the USA, Sweden and Australia (Eschenbach et al 1984;McDonald et al 1992;Holst et al 1994) have used diff erent methodologies to examine the association between abnormal genital tract fl ora, either in the form of BV or the presence of BV associated organisms, and adverse outcomes of pregnancy. Th e majority of these studies show a statistically signifi cant association between abnormal genital tract fl ora and PTB and the degree of risk was greater the earlier in pregnancy at which the abnormal fl ora was detected (Lamont et al 2004).…”

Section: Treatment Timingmentioning

confidence: 98%

Infection and antibiotics in the aetiology, prediction and prevention of preterm birth

Oliver

Lamont

2013

Journal of Obstetrics and Gynaecology

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Spontaneous preterm labour and delivery is a syndrome comprising diverse pathological pathways that result in labour and delivery before term. It is recognised that multiple pathological processes are involved, and infection has been well studied and firmly established as a cause. Although the molecular mechanisms responsible for this process have been identified, there is a lack of consensus about effective antibiotic intervention. Systematic reviews of the few well conducted studies suggest that antibiotics active against bacterial vaginosis or related organisms (clindamycin) given to appropriate women (those with objective evidence of abnormal genital tract flora), and used early in pregnancy (< 22 completed weeks of gestation) before irreversible inflammatory damage occurs, can reduce the rate of preterm birth. There is a need for well constructed trials to understand the vaginal microbiome and how the different types of maternal immune response influences outcome.

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Prenatal microbiological risk factors associated with preterm birth

Cited by 29 publications

References 0 publications

High-frequency Oscillatory Ventilation

High-frequency Oscillatory Ventilation

Vaginal Microbiome: Rethinking Health and Disease

Infection and antibiotics in the aetiology, prediction and prevention of preterm birth

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