Cox Ciara, Saxena Nita, Watt Alison P, Gannon Caroline, McKenna James P, Fairley Derek J, Sweet David, Shields Michael D, L Cosby Sara, Coyle Peter V
a Department of Microbiology , Belfast Health and Social Care Trust , Belfast , Northern Ireland , UK .
b Centre for Infection and Immunity, Queen's University Belfast , Northern Ireland , UK .
J Matern Fetal Neonatal Med. 2016 Nov;29(22):3646-51. doi: 10.3109/14767058.2016.1140734. Epub 2016 Feb 26.
To assess the association of vaginal commensal and low-grade pathogenic bacteria including Ureaplasma parvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium, Group B streptococcus (GBS), and Gardnerella vaginalis, in women who delivered preterm at less than 37-week gestation in the presence or absence of inflammation of the chorioamnionitic membranes.
A case control study involving women who delivered before 37-week gestation with and without inflammation of chorioamnionitic membranes. A total of 57 placental samples were histologically examined for polymorphonuclear leukocyte infiltration of placental tissue for evidence of chorioamnionitis, and by type-specific nucleic acid amplification for evidence of infection with one or more of the target bacteria. Demographic data were collected for each mother.
Among the 57 placental samples, 42.1% had chorioamnionitis and 24.6% delivered in the second trimester of pregnancy; U. parvum, U. urealyticum, G. vaginalis, and GBS were all detected in the study with respective prevalence of 19.3%, 3.5%, 17.5%, and 15.8%; M. genitalium and M. hominis were not detected. U. parvum was significantly associated with chorioamnionitis (p = 0.02; OR 5.0; (95% CI 1.2-21.5) and was more common in women who delivered in the second (35.7%) compared to the third trimester of pregnancy (13.9%). None of the other bacteria were associated with chorioamnionitis or earlier delivery, and all G. vaginalis-positive women delivered in the third trimester of pregnancy (p = 0.04).
The detection of U. parvum in placental tissue was significantly associated with acute chorioamnionitis in women presenting in extreme preterm labor.
评估妊娠小于37周早产且伴有或不伴有绒毛膜羊膜炎的女性阴道共生菌和低致病性细菌（包括微小脲原体、解脲脲原体、人型支原体、生殖支原体、B族链球菌（GBS）和阴道加德纳菌）之间的关联。
一项病例对照研究，纳入妊娠37周前分娩且伴有或不伴有绒毛膜羊膜炎的女性。对57份胎盘样本进行组织学检查，以检测胎盘组织中多形核白细胞浸润情况，作为绒毛膜羊膜炎的证据，并通过型特异性核酸扩增检测一种或多种目标细菌感染的证据。收集每位母亲的人口统计学数据。
在57份胎盘样本中，42.1%有绒毛膜羊膜炎，24.6%在妊娠中期分娩；研究中检测到微小脲原体、解脲脲原体、阴道加德纳菌和GBS，其各自的患病率分别为19.3%、3.5%、17.5%和15.8%；未检测到生殖支原体和人型支原体。微小脲原体与绒毛膜羊膜炎显著相关（p = 0.02；OR 5.0；（95%CI 1.2 - 21.5）），在妊娠中期分娩的女性中更常见（35.7%），而在妊娠晚期分娩的女性中为13.9%。其他细菌均与绒毛膜羊膜炎或早产无关，所有阴道加德纳菌阳性的女性均在妊娠晚期分娩（p = 0.04）。
在极早早产的女性中，胎盘组织中微小脲原体的检测与急性绒毛膜羊膜炎显著相关。
