title: Coexistence of Ureaplasma and chorioamnionitis is associated with prolonged mechanical ventilation.
abstract: BACKGROUND
  Both histologic chorioamnionitis (HCAM) and Ureaplasma infection are considered important contributors to perinatal lung injury. We tested the hypothesis that coexistence of maternal HCAM and perinatal Ureaplasma exposure increases the risk of prolonged mechanical ventilation in extremely low-birthweight (ELBW) infants.
  
  
  METHODS
  A retrospective cohort study was carried out of all ELBW infants born between January 2008 and December 2013 at a single academic center. Placental pathology and gastric fluid Ureaplasma data were available for all infants. Culture and polymerase chain reaction were used to detect Ureaplasma in gastric fluid. Prolonged mechanical ventilation was defined as mechanical ventilation that began within 28 days after birth and continued.
  
  
  RESULTS
  Of 111 ELBW infants enrolled, 84 survived beyond 36 weeks of postmenstrual age (PMA) and were included in the analysis. Eighteen infants (21.4%) had both HCAM and Ureaplasma exposure. Seven infants (8.3%) required mechanical ventilation beyond 36 weeks of PMA. Coexistence of HCAM and Ureaplasma in gastric fluid was significantly associated with prolonged mechanical ventilation after adjustment for gestational age, sex, mode of delivery, and use of macrolide antibiotics (OR, 8.7; 95%CI: 1.1-67.2).
  
  
  CONCLUSIONS
  Coexistence of maternal HCAM and perinatal Ureaplasma exposure significantly increases the risk of prolonged mechanical ventilation in ELBW infants.
authors.affiliation: Department of Pediatrics, Asan Medical Center Children's Hospital, Seoul, Korea.
authors.forename: Euiseok
authors.identifier: http://orcid.org/0000-0003-0693-5627
authors.initials: E
authors.lastname: Jung
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.|Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Chang Won
authors.initials: CW
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea.
authors.forename: Su Yeong
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Tae-Jung
authors.initials: TJ
authors.lastname: Sung
authors.affiliation: Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Haeryoung
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Kyoung Un
authors.initials: KU
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Han-Suk
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.|Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Beyong Il
authors.initials: BI
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung-Hwan
authors.initials: JH
authors.lastname: Choi
mesh_terms: D001431:Bacteriological Techniques; D001997:Bronchopulmonary Dysplasia / Q000382:microbiology / Q000628:therapy; D002821:Chorioamnionitis / Q000382:microbiology*; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000235:genetics; D005260:Female; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000382:microbiology / Q000628:therapy; D008297:Male; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000382:microbiology*; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014509:Ureaplasma / Q000302:isolation & purification*; D016869:Ureaplasma Infections / Q000150:complications*
chemical_list: D004269:DNA, Bacterial
keywords: Ureaplasma infection; bronchopulmonary dysplasia; chorioamnionitis; extremely low-birthweight; infant