title: Prolonged progesterone administration is associated with less frequent cervicovaginal colonization by Ureaplasma urealyticum during pregnancy - Results of a pilot study.
abstract: Preterm birth is a leading cause of perinatal mortality and morbidity. Heavy cervicovaginal Ureaplasma colonization is thought to play a role in the pathogenesis of preterm birth. The administration of vaginal progesterone has been shown to reduce the incidence of preterm birth in women with short cervical length. Steroid hormones seem to modulate the presence of microorganisms in the vagina. The aim of this study was to assess whether the treatment with vaginal progesterone could reduce the incidence of preterm birth and cervicovaginal colonization by Ureaplasma urealyticum in a cohort of pregnant women with threatened preterm labor.
  
  
  
  A cohort of 63 females who presented with regular contractions and/or short cervical length between 24-32 weeks of gestation were recruited into a prospective study. 70% of patients had been treated with vaginal progesterone prior to recruitment and these patients continued with the treatment until birth. All patients were tested for the presence of cervicovaginal Ureaplasma urealyticum colonization at admission. The primary endpoint was preterm birth before 37 weeks.
  
  
  
  The incidence of preterm delivery was significantly increased in patients who tested positive for Ureaplasma urealyticum. Prolonged vaginal progesterone administration was associated with less frequent cervicovaginal colonization by U. urealyticum. Cervicovaginal colonization by U. urealyticum and absence of progesterone treatment were identified as two independent risk factors for preterm delivery.
  
  
  
  Our results demonstrate the beneficial effects of progesterone administration in reducing the incidence of cervicovaginal colonization by Ureaplasma urealyticum.
authors.affiliation: Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic. Electronic address: michalkoucky@seznam.cz.
authors.forename: Michal
authors.initials: M
authors.lastname: Koucký
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Karin
authors.initials: K
authors.lastname: Malíčková
authors.affiliation: Department of Physiology, Development and Neuroscience, University of Cambridge, United Kingdom.
authors.forename: Tereza
authors.initials: T
authors.lastname: Cindrová-Davies
authors.affiliation: Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Jan
authors.initials: J
authors.lastname: Smíšek
authors.affiliation: Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Vráblíková
authors.affiliation: Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Andrej
authors.initials: A
authors.lastname: Černý
authors.affiliation: Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Patrik
authors.initials: P
authors.lastname: Šimják
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Miroslava
authors.initials: M
authors.lastname: Slováčková
authors.affiliation: Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Antonín
authors.initials: A
authors.lastname: Pařízek
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Zima
mesh_terms: D000282:Administration, Intravaginal; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D002584:Cervix Uteri / Q000382:microbiology*; D015331:Cohort Studies; D018153:Czech Republic / Q000453:epidemiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology / Q000628:therapy*; D011374:Progesterone / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D016869:Ureaplasma Infections / Q000453:epidemiology / Q000628:therapy*; D016990:Ureaplasma urealyticum / Q000276:immunology*; D014621:Vagina / Q000382:microbiology*
chemical_list: D000890:Anti-Infective Agents; D011374:Progesterone
keywords: Cervical incompetence; Preterm labor; Progesterone; Ureaplasma urealyticum