title: Placental Infection With Ureaplasma species Is Associated With Histologic Chorioamnionitis and Adverse Outcomes in Moderately Preterm and Late-Preterm Infants.
abstract: OBJECTIVE
  The human Ureaplasma species are the microbes most frequently isolated from placentae of women who deliver preterm. The role of Ureaplasma species has been investigated in pregnancies at <32 weeks of gestation, but currently no studies have determined the prevalence of ureaplasmas in moderately preterm and late-preterm (hereafter, "moderate/late preterm") infants, the largest cohort of preterm infants.
  
  
  METHODS
  Women delivering moderate/late preterm infants (n = 477) and their infants/placentae (n = 535) were recruited, and swab specimens of chorioamnion tissue, chorioamnion tissue specimens, and cord blood specimens were obtained at delivery. Swab and tissue specimens were cultured and analyzed by 16S ribosomal RNA polymerase chain reaction (PCR) for the presence of microorganisms, while cord blood specimens were analyzed for the presence of cytokines, chemokines, and growth factors.
  
  
  RESULTS
  We detected microorganisms in 10.6% of 535 placentae (443 were delivered late preterm and 92 were delivered at term). Significantly, Ureaplasma species were the most prevalent microorganisms, and their presence alone was associated with histologically confirmed chorioamnionitis in moderate/late preterm and term placentae (P < .001). The presence of ureaplasmas in the chorioamnion was also associated with elevated levels of granulocyte colony-stimulating factor (P = .02).
  
  
  CONCLUSIONS
  These findings have important implications for infection and adverse pregnancy outcomes throughout gestation and should be of major consideration for obstetricians and neonatologists.
authors.affiliation: Institute of Health and Biomedical Innovation, Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
authors.forename: Emma L
authors.initials: EL
authors.lastname: Sweeney
authors.affiliation: Division of Neonatology.
authors.forename: Suhas G
authors.initials: SG
authors.lastname: Kallapur
authors.affiliation: Division of Neonatology.
authors.forename: Tate
authors.initials: T
authors.lastname: Gisslen
authors.affiliation: Division of Maternal and Fetal Medicine.
authors.forename: Donna S
authors.initials: DS
authors.lastname: Lambers
authors.affiliation: Division of Immunobiology, Cincinnati Children's Hospital Medical Centre, Ohio.
authors.forename: Claire A
authors.initials: CA
authors.lastname: Chougnet
authors.affiliation: Institute of Health and Biomedical Innovation, Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
authors.forename: Sally-Anne
authors.initials: SA
authors.lastname: Stephenson
authors.affiliation: Division of Neonatology.
authors.forename: Alan H
authors.initials: AH
authors.lastname: Jobe
authors.affiliation: Institute of Health and Biomedical Innovation, Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Knox
mesh_terms: D000293:Adolescent; D000328:Adult; D002821:Chorioamnionitis / Q000453:epidemiology*; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D010922:Placenta Diseases / Q000453:epidemiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D016869:Ureaplasma Infections / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D016207:Cytokines
keywords: Ureaplasma species; chorioamnionitis; cord blood; cytokines; infection; placenta; pregnancy outcomes; preterm birth