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To determine the prevalence of  Ureaplasma  spp. DNA and its load in the cervical fluid in women with preterm labor with intact membranes (PTL) complicated by intra-amniotic infection (the presence of both microbial invasion of the amniotic cavity and intra-amniotic inflammation) or sterile intra-amniotic inflammation (the presence of intra-amniotic inflammation alone). Overall, 115 women with singleton pregnancies complicated by PTL between gestational ages of 22 + 0 and 34 + 6 weeks were included in this study. Paired amniotic and cervical fluid samples were collected at the time of admission via transabdominal amniocentesis using a Dacron polyester swab. Microbial invasion of the amniotic cavity was diagnosed based on a combination of culture and molecular biology methods. Intra-amniotic inflammation was determined based on the concentration of interleukin-6 in the amniotic fluid. Bacterial and  Ureaplasma  spp. DNA loads were assessed in the cervical fluid using PCR. Intra-amniotic infection and sterile inflammation were identified in 14% (16/115) and 25% (29/115) of the women, respectively.  Ureaplasma  spp. DNA in the cervical fluid was identified in 51% (59/115) of women. The presence of  Ureaplasma  spp. DNA in the cervical fluid was higher in women with intra-amniotic infection (75% (12/16)) and sterile intra-amniotic inflammation (76% (22/29)) than in women without intra-amniotic inflammation (36% (25/70);  p  = .0002). Concurrent presence of  Ureaplasma  spp. and  Mycoplasma hominis  DNA was higher in women with intra-amniotic infection (42% (5/12)) than women with sterile intra-amniotic inflammation (7% (2/29)) and women without intra-amniotic inflammation (7% (5/70);  p  = .001). There were no differences in the load of  Ureaplasma  spp. DNA in the cervical fluid among women with intra-amniotic infection, sterile intra-amniotic inflammation, and those without intra-amniotic inflammation (median values; infection: 1.2 × 10 4  copies DNA/mL; sterile: 5.0 × 10 5  copies DNA/mL; without: 8.4 × 10 4  copies DNA/mL;  p  = .18). In PTL , both forms of intra-amniotic inflammation were associated with a higher prevalence of  Ureaplasma  spp. DNA in the cervical fluid. The presence of intra-amniotic infection was related to a higher rate of concurrent  Ureaplasma  spp. and  M. hominis  DNA in the cervical fluid.

the journal of maternal-fetal and neonatal medicine

Intra-amniotic infection and sterile intra-amniotic inflammation in women with preterm labor with intact membranes are associated with a higher rate of  Ureaplasma  species DNA presence in the cervical fluid