Vaginal colonization by ureaplasma species in early pregnancy; role in preterm birth

ABSTRACT

Preterm birth and low birth weight are the leading causes of neonatal mortality and morbidity. Ascending genital tract infections contribute to up to 50% of premature deliveries particularly those occurring before 34 weeks of gestation. Genital mycoplasmas including ureaplasmas species have been implicated in infertility, spontaneous abortion, still birth, premature birth, low birth weight and perinatal morbidity and mortality. Was to examine the association between colonization by two newly classified species of genital ureaplasmas [ureaplasma parvum and ureaplasma urealyticum] in early pregnancy and subsequent late abortion-or preterm birth at less than 34 weeks of gestation using PCR technique. A total of 160 women with singleton pregnancies at less than eleven weeks were subjected to full history and clinical examination, sterile cotton swabs were used to obtain vaginal material from the posterior fornix and these swab specimens were examined by PCR method, all pregnant women were followed up till delivery. Ureaplasma parvum was detected in a significantly larger number of women in the preterm birth group 10/15 [66.67%] versus 68/145 [46.89%] in the control group p = [0.037]. A significantly larger number of women had a past history of preterm birth at < 37 weeks of gestation in the preterm birth group p = [0.009]. In addition, a significant larger number of women were treated with antibiotics before 22 weeks of gestation in preterm birth group than in control group p = [0.005]. Thus detection of Ureaplama parvum in the vagina, use of antibiotics for incidental inflammatory conditions before 22 weeks of gestation, and past history of preterm birth were independently associated with late abortion or early preterm birth. In conclusion, vaginal colonization with urea-plasma parvum but not ureaplasma urealyticum-is associated with early preterm birth