Τίτλος:
Maternal genital colonization with Ureaplasma urealyticum promotes
preterm delivery: Association of the respiratory colonization of
premature infants with chronic lung disease and increased mortality
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background. Infection of the chorioamnion with Ureaplasma urealyticum
has been associated with low birth weight. Respiratory tract
colonization in preterm infants has been associated with the development
of chronic lung disease (CLD). The purpose of the present study was to
determine the frequency of colonization of the mother’s vagina and the
preterm infant’s respiratory tract and to associate U. urealyticum with
premature birth and with development of CLD in the newborn.
Methods. The present prospective study involved 126 mothers with preterm
delivery and 125 mothers with full-term delivery, as well as their
offspring. Vaginal secretion specimens were obtained from each mother
before delivery. Rhinopharyngeal secretion or tracheal lavage specimens
were collected after the birth of each premature and full-term infant
and then periodically during hospitalization.
Results. Vaginal Ureaplasma colonization occurred among 36.5% of
mothers with preterm delivery and among 38% of mothers with full-term
delivery. The rate of vertical transmission was 33% and 17% for
mothers with preterm delivery and mothers with full-term delivery,
respectively. The transmission rate for infants, according to birth
weight, was as follows: 60%, for infants with a birth weight of <1000
g; 50%, for infants with a birth weight of 1000-1500 g; and 15.3%, for
infants with a birth weight of greater than or equal to1500 g (P =
.001). The median gestational age of preterm infants born to colonized
mothers was 28.5 weeks, and that of preterm infants born to noncolonized
mothers was 32 weeks (P < .001). The median birth weight of colonized
preterm infants was 1135 g, and that of noncolonized infants was 1670 g
(P < .001). Twenty-four percent of preterm infants and 10% of full-term
infants were colonized with U. urealyticum. Of colonized preterm
infants, 27% developed CLD, compared with 9% of noncolonized infants
(P = .03). Mortality was significantly higher among colonized preterm
infants (P = .003).
Conclusions. The rate of vertical transmission is highest among preterm
infants with a birth weight of <1500 g. Vaginal colonization with
Ureaplasma organisms is associated with premature delivery. Colonization
of the respiratory tract of infants is associated with the development
of CLD and with increased mortality.
Συγγραφείς:
Kafetzis, DA
Skevaki, CL
Skouteri, V
Gavrili, S
Peppa, K
and Kostalos, C
Petrochilou, V
Michalas, S
Περιοδικό:
Clinical Infectious Diseases
Εκδότης:
OXFORD UNIV PRESS INC
