Neonatal Med.  2017 Aug;24(3):123-128. 10.5385/nm.2017.24.3.123.

Clinical Effects of Ureaplasma urealyticum Colonization in Maternal Vaginal Fluid at Second Trimester on Neonatal Outcomes of Premature Infant ≤35 Weeks' Gestational Age

• Han YS
• Chun SH
• Chun JY
• Sung TJ

• KMID: 2388976
• DOI: http://doi.org/10.5385/nm.2017.24.3.123

Abstract

PURPOSE
The purpose of this study was to evaluate the relationship between maternal genital Ureaplasma urealyticum colonization in the second trimester and the neonatal outcomes.
METHODS
We studied 577 premature infants born at ≤35 weeks' gestational age (GA) at Hallym University, Kangnam Sacred Heart Hospital from January 2008 to December 2014. Maternal vaginal specimens were collected and polymerase chain reaction and/or culture tests were done in the second trimester of pregnancy. The subjects were divided into 2 groups: a Uu colonization-positive group (UU) and a Uu-negative (control) group. Subgroup analyses were performed in extremely premature (23-28 weeks' GA) and premature (29-35 weeks' GA) infants. Various clinical outcomes were compared.
RESULTS
Of 577 preterm infants, 311 were delivered with maternal Uu infection (UU, 53.9%). Mean GA (30.0±3.6 weeks vs. 31.0±3.7 weeks, P=0.010) and birth weight (1,685.6±680.4 g vs. 1,932.7±733.1 g, P=0.003) were lower in the UU group than in controls. However, there were no significant differences in GA and birth weight in extremely premature group. Premature labor (P=0.002) and histological chorioamnionitis (P=0.032) was significantly more common in the UU group, especially in mothers who delivered in third trimester (29-35 weeks' GA). In particular, the incidence of moderate-to-severe BPD was statistically higher in UU extremely premature group (60.8% vs. 32.2%) (P=0.001).
CONCLUSION
Maternal colonization with Uu was associated with an increase in premature delivery and lower birth weights. Moderate-to-severe BPD was more common in premature infants born at ≤28 weeks' GA with maternal Uu colonization.

Keyword

Bronchopulmonary dysplasia; Prematurity; Ureaplasma urealyticum

MeSH Terms

Birth Weight
Bronchopulmonary Dysplasia
Chorioamnionitis
Colon*
Female
Gestational Age*
Heart
Humans
Incidence
Infant
Infant, Newborn
Infant, Premature*
Mothers
Obstetric Labor, Premature
Polymerase Chain Reaction
Pregnancy
Pregnancy Trimester, Second*
Pregnancy Trimester, Third
Ureaplasma urealyticum*
Ureaplasma*