The Role of Inflammation and Infection in Preterm Birth

Romero, Roberto; Espinoza, Jimmy; Gonçalves, Luís F.; Kusanovic, Juan Pedro; Friel, Lara A.; Hassan, Sonia S.

doi:10.1055/s-2006-956773

Cited by 787 publications

(666 citation statements)

References 187 publications

(247 reference statements)

Supporting

Mentioning

618

Contrasting

Unclassified

Order By: Relevance

“…The Chi-square statistic then tests that the observed occurrence in any cell is unlikely to differ from that expected by chance. With most displays comparing two rows by week of gestation (23,24,25,26,27), a "significant p value" does not inform us about which of the many comparisons within this 2×5 array is what makes the p value significant.…”

Section: Discussionmentioning

confidence: 99%

“…These histologic characteristics are considered manifestations of a fetal inflammatory response, a recognized antecedent of preterm labor. 24 The numbers of colony forming units/gram of tissue also exceed the levels generally associated with contamination. Contamination of tissue specimens obtained after antiseptic preparation usually occurs with recovery of very low levels of microorganisms (e.g.…”

Section: Commentmentioning

confidence: 99%

“…Indeed, our findings are consistent with other evidence that infectious/inflammatory phenomena contribute to the onset of labor before the third trimester. 23,24 Placentas that had neutrophils in fetal stem vessels within the chorion or in the vessels of the cord (identified as fetal vasculitis) had higher rates of microorganism recovery than placentas without fetal vasculitis. These histologic characteristics are considered manifestations of a fetal inflammatory response, a recognized antecedent of preterm labor.…”

Section: Commentmentioning

confidence: 99%

“…This is what would be expected with low-virulence organisms, and what has been seen with cultures of amniotic fluid and membranes from preterm pregnancies. 23,24 In a separate study of term placentas, we used the same sample collection and culture methods for CS delivered placentas and found that only 17% (2/12) of specimens yielded a microorganism when cultured. This is similar to our recovering organisms from approximately 20% of preeclamptic placentas delivered before the 28 th post-menstrual week.…”

Section: Commentmentioning

confidence: 99%

See 3 more Smart Citations

Colonization of second-trimester placenta parenchyma

Onderdonk¹,

Hecht²,

McElrath³

et al. 2008

American Journal of Obstetrics and Gynecology

128

103

View full text Add to dashboard Cite

Objective-The overtly healthy, non-pregnant uterus harbors bacteria, Mycoplasma and Ureaplasma. The extent of colonization remains elusive, as are relationships between isolated microorganisms, preterm labor and fetal inflammation.Study Design-Biopsies of chorion parenchyma from 1083 placentas delivered before the beginning of the 28 th week of gestation were cultured, and the placenta was examined histologically. The frequencies of individual microorganisms and groups of microorganisms were evaluated in strata of processes leading to preterm delivery, routes of delivery, gestational age, and placenta morphology Results-Placentas delivered by cesarean section with preeclampsia had the lowest bacterial recovery rate (25%). Preterm labor had the highest rates, which decreased with increasing gestational age from 79% at 23 weeks to 43% at 27 weeks. The presence of microorganisms in placenta Conclusions-The high rate of colonization appears to coincide with phenomena associated with preterm delivery and gestational age. The presence of microorganisms within placenta parenchyma is biologically important.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

See 2 more Smart Citations

Colonization of second-trimester placenta parenchyma

Onderdonk¹,

Hecht²,

McElrath³

et al. 2008

American Journal of Obstetrics and Gynecology

128

103

View full text Add to dashboard Cite

show abstract

“…Intrauterine infection or inflammation caused by various bacteria, including Escherichia coli, Gardnerella vaginalis, anaerobic bacteria, and genital mycoplasmas, can lead to preterm birth (4,5). Animal models of bacterial componentinduced preterm birth have been established (6,7).…”

mentioning

confidence: 99%

Human thioredoxin-1 attenuates the rate of lipopolysaccharide-induced preterm delivery in mice in association with its anti-inflammatory effect

et al. 2016

View full text Add to dashboard Cite

Background:Maternal intrauterine infection/inflammation represents the major etiology of preterm delivery and the leading cause of neonatal mortality and morbidity. The aim of this study was to investigate the anti-inflammatory properties of thioredoxin-1 in vivo and its potential ability to attenuate the rate of inflammation-induced preterm delivery. Methods: Two intraperitoneal injections of lipopolysaccharide from Escherichia coli were administered in pregnant mice on gestational day 15, with a 3-h interval between the injections. From either 1 h before or 1 h after the first lipopolysaccharide injection, mice received three intravenous injections of either recombinant human thioredoxin-1, ovalbumin, or vehicle, with a 3-h interval between injections. results: Intraperitoneal injection of lipopolysaccharide induced a rise of tumor necrosis factor-α, interferon-γ, monocyte chemotactic protein 1, and interleukin-6 in maternal serum levels and provoked preterm delivery. Recombinant human thoredoxin-1 prevented the rise in these proinflammatory cytokine levels. After the inflammatory challenge, placentas exhibited severe maternal vascular dilatation and congestion and a marked decidual neutrophil activation. These placental pathological findings were ameliorated by recombinant human thioredoxin-1, and the rate of inflammation-induced preterm delivery was attenuated. conclusion: Thioredoxin-1 may thus represent a novel effective treatment to delay inflammation-induced preterm delivery.t he estimated number of preterm births (defined as birth before gestational week 37) worldwide was 15 million in 2010 (11.1%) (1). Preterm birth is the most frequent cause of infant mortality and leads to one million deaths per year. Premature infants face increased risk of neonatal complications, such as intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy, and necrotizing enterocolitis as well as increased risk of adult-onset obesity, diabetes, and hypertension (2,3).Intrauterine infection or inflammation caused by various bacteria, including Escherichia coli, Gardnerella vaginalis, anaerobic bacteria, and genital mycoplasmas, can lead to preterm birth (4,5). Animal models of bacterial componentinduced preterm birth have been established (6,7).Thioredoxin-1 (TRX), originally cloned as a soluble factor called adult T-cell leukemia-derived factor (8), is one of the most important molecules controlling the redox regulation system and contains a redox-active disulfide/dithiol within the conserved active site sequence Cys 32 -Gly-Pro-Cys 35 (ref. (9)). TRX has a pivotal role in scavenging reactive oxygen species (ROS) with peroxiredoxins, and thus, it prevents apoptosis of various cells (10). Moreover, circulating TRX inhibits neutrophil infiltration into the sites of inflammation by blocking the adhesion of lipopolysaccharide (LPS)-stimulated neutrophils on endothelial cells (11). Overexpression of human TRX in transgenic mice induced resistance to harmful conditions, including thioacetamide-or LPS-induced acute hepati...

show abstract

Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Maternal infection has been implicated in the pathogenesis of preterm birth through intrauterine inflammatory response. Chlamydia, gonorrhea, and syphilis are among the most common sexually transmitted infections worldwide, but studies on their association with preterm birth are sparse. OBJECTIVETo examine the association between maternal chlamydia, gonorrhea, and syphilis infections in pregnancy and the risk of preterm birth in a large population-based study in the US. DESIGN, SETTING, AND PARTICIPANTSThis population-based retrospective cohort study examined nationwide birth certificate data from the US National Vital Statistics System between 2016 and 2019. All mothers who had a singleton live birth and available data on chlamydia, gonorrhea, or syphilis infection before or during pregnancy and gestational age at birth were included in analysis. EXPOSURES Sexually transmitted infection (chlamydia, gonorrhea, or syphilis) occurring before or during pregnancy. MAIN OUTCOMES AND MEASURES Preterm birth, defined as gestational age less than 37 weeks. RESULTS This study included 14 373 023 mothers (mean [SD] age 29 [5.8] years; Hispanic, 3 435 333 [23.9%]; non-Hispanic Asian, 912 425 [6.3%]; non-Hispanic Black, 2 058 006 [14.3%]; and non-Hispanic White, 7 386 568 [51.4% ]). Among the mothers, 267 260 (1.9%) had chlamydia, 43 147 (0.3%) had gonorrhea, and 16 321 (0.1%) had syphilis. Among the newborns, 1 146 800 (8.0%) were preterm births. The rate of preterm birth was 9.9%, 12.2%, and 13.3% among women with chlamydia, gonorrhea, and syphilis infection, respectively. After adjustment for sociodemographic and medical and/or health factors, the adjusted odds ratio of preterm birth was 1.03 (95% CI, 1.02-1.04) for chlamydia, 1.11 (95% CI, 1.08-1.15) for gonorrhea, 1.17 (95% CI, 1.11-1.22) for syphilis, and 1.06 (95% CI, 1.05-1.07) for any of these sexually transmitted infections comparing mothers with these conditions and those without. CONCLUSIONS AND RELEVANCEMaternal sexually transmitted infections (gonorrhea, syphilis, or chlamydia) were associated with an increased risk of preterm birth. Pregnant women with sexually transmitted infections before or during pregnancy might benefit from targeted prevention for preterm birth.

show abstract

The Role of Inflammation and Infection in Preterm Birth

Cited by 787 publications

References 187 publications

Colonization of second-trimester placenta parenchyma

Colonization of second-trimester placenta parenchyma

Human thioredoxin-1 attenuates the rate of lipopolysaccharide-induced preterm delivery in mice in association with its anti-inflammatory effect

Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States

Contact Info

Product

Resources

About