Ureaplasma urealyticum: no independent role in the pathogenesis of bronchopulmonary dysplasia.
BACKGROUND
Ureaplasma urealyticum has been linked to short and long-term morbidity of preterm infants. We wanted to analyze if it has an independent role in the pathogenesis of bronchopulmonary dysplasia if prenatal history with possible exposure to intrauterine infection is taken into account.


METHODS
Lower respiratory tract colonization with U. urealyticum was analyzed from 49 infants born before the 30th week of gestation. The need for supplemental oxygen at the age of 28 days and 36 gestational weeks was studied.


RESULTS
Forty-five percent of the 33 infants born after spontaneous onset of labor were colonized with U. urealyticum, while none of the electively born were. If analyzed based on the Ureaplasma colonization, bronchopulmonary dysplasia was more common in the colonized infants at the age of 28 days (OR 4.57, 95% CI 1.18-17.68), but not at the gestational age of 36 weeks (OR 1.00). Based on the prenatal history, the OR of bronchopulmonary dysplasia in infants born after spontaneous onset of labor was greater than in infants born electively both at the age of 28 days (OR 4.33, 95% CI 0.83-22.75) and at 36 weeks of gestation (OR 2.8, 95% CI 0.30-26.42).


CONCLUSIONS
If possible exposure to intra-amniotic inflammation is taken into account, U. urealyticum seems not to have an independent role in the pathogenesis of bronchopulmonary dysplasia. Its role has been overemphasized, as it is the most common cause of intra-amniotic bacterial infection.
Aaltonen
Riikka
R
Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland. riikka.aaltonen@tyks.fi
Vahlberg
Tero
T
Lehtonen
Liisa
L
Alanen
Anna
A
D001997:Bronchopulmonary Dysplasia / Q000209:etiology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D007752:Obstetric Labor, Premature / Q000503:physiopathology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000503:physiopathology*; D016869:Ureaplasma Infections / Q000503:physiopathology*; D016990:Ureaplasma urealyticum