Study

Infants Born Pre-term Often Infected with Genital Mycoplasmas

About one out of four infants born before 32 weeks gestation has a positive umbilical blood culture for ureaplasma urealyticum or mycoplasma hominis or both, putting them at risk for systemic inflammatory response syndrome and most likely bronchopulmonary dysplasia, according to findings from the Alabama Preterm Birth Study.

U urealyticum and M hominis are part of the normal flora in the female lower genital tract, where they are considered non-pathogenic. However, the two mycoplasmas are also the most frequent cause of chorioamnionitis and are associated with spontaneous pre-term labor and pre-term premature rupture of the fetal membranes (PPROM), investigators note in the American Journal of Obstetrics and Gynecology for January.

In their prospective study, Dr Robert L Goldenberg, of the Drexel University College of Medicine in Philadelphia, and colleagues at the University of Alabama, - Birmingham Medical School examined the risk factors and outcomes among very premature infants who had umbilical cord blood cultures performed for U urealyticum and M hominis.

Included were 351 infants delivered between 23 and 32 weeks. Eighty-two infants (23.4 per cent) had positive cultures for one or both of the organisms. The incidence was highest in infants born before 25 weeks (44.4 per cent), the authors report, and lowest in those born after 29 weeks (18.5 per cent). Other risk factors for a positive for a positive U urealyticum or M hominis culture were nonwhite race, maternal age younger than 20 years, and spontaneous versus indicated delivery.

Compared with neonates with negative cultures, those with positive cultures were significantly more likely to have systemic inflammatory response syndrome (25.7 per cent versus 41.3 per cent) and bronchopulmonary dysplasia (10.1 per cent versus 26.8 per cent). Odds ratios adjusted for race, sex, and gestational age were 1.86 (p = .026) and 1.99 (p = .0872), respectively.

Reuters Health