Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery.
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.
Andrews
William W
WW
Department of Obstetrics and Gynecology, Center for Research in Women's Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Goldenberg
Robert L
RL
Hauth
John C
JC
Cliver
Suzanne P
SP
Conner
Michael
M
Goepfert
Alice R
AR
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*