title: Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery.
abstract: OBJECTIVE
  This study was undertaken to determine whether endometrial microbial colonization or plasma cell endometritis is increased after spontaneous versus indicated preterm delivery or a spontaneous term delivery.
  
  
  METHODS
  Postpartum, endometrial specimens were obtained after a spontaneous (mean 83, +/- 17.6 days) or indicated (mean 83, +/- 16.7 days) preterm delivery before 34 weeks' gestation and after a spontaneous term delivery (mean 82, +/- 15.7 days; P=.980). Cultures for aerobic and anaerobic bacteria, Trichomonas vaginalis, and genital mycoplasmas were performed. Histologic endometritis was defined as the presence of plasma cells.
  
  
  RESULTS
  The study population (n=820) was 71% black, 29% white, 69% unmarried, and 31% had less than 12 years of education. Endometrial cultures were positive for at least 1 microorganism in 82% of the women. No significant difference in positive endometrial cultures were observed among women after a spontaneous versus an indicated preterm delivery (85% vs 79%, P=.102), or a spontaneous preterm versus a spontaneous term delivery (85% vs 81%, P=.123). Plasma cell endometritis was present in 39% of 506 specimens sufficient for histologic examination and was also similar in the three groups (P=.160).
  
  
  CONCLUSIONS
  Microbial colonization of the endometrium and plasma cell endometritis are similar 3 months after spontaneous or indicated preterm or term births. Therefore, chronic infection and inflammation of the endometrium (documented at 3 months postpartum) do not appear to be risk factors for subsequent delivery in women with a prior spontaneous delivery less than 34 weeks' gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Center for Research in Women's Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: William W
authors.initials: WW
authors.lastname: Andrews
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
authors.forename: John C
authors.initials: JC
authors.lastname: Hauth
authors.forename: Suzanne P
authors.initials: SP
authors.lastname: Cliver
authors.forename: Michael
authors.initials: M
authors.lastname: Conner
authors.forename: Alice R
authors.initials: AR
authors.lastname: Goepfert
mesh_terms: D002584:Cervix Uteri / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004716:Endometritis / Q000453:epidemiology*; D004717:Endometrium / Q000382:microbiology*; D005260:Female; D006801:Humans; D009174:Mycoplasma / Q000302:isolation & purification; D010950:Plasma Cells; D011247:Pregnancy; D047928:Premature Birth / Q000382:microbiology*