Open AccessImpact of microbial invasion of amniotic cavity and the type of microorganisms on short‐term neonatal outcome in women with preterm labor and intact membranes
Author(s) -
Cobo Teresa,
Vives Irene,
RodríguezTrujillo Adriano,
Murillo Clara,
Ángeles Martina A.,
Bosch Jordi,
Vergara Andrea,
Gratacós Eduard,
Palacio Montse
Publication year - 2017
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13095
Subject(s) - chorioamnionitis , amniotic fluid , ureaplasma , medicine , obstetrics , ureaplasma urealyticum , gestation , gestational age , pregnancy , mycoplasma hominis , cervical cerclage , amniotic sac , fetus , physiology , mycoplasma , microbiology and biotechnology , biology , genetics
Abstract Introduction The objective of this study was to evaluate the impact of microbial invasion of the amniotic cavity and the type of microorganisms on pregnancy and short‐term neonatal outcomes in women with preterm labor. Material and methods Prospective observational cohort study including women with preterm labor from 22.0 to 36.0 weeks. Microbial invasion of the amniotic cavity was defined based on amniotic fluid aerobic/anaerobic/mycoplasma cultures, and intra‐amniotic inflammation on amniotic fluid interleukin‐6 levels. Demographic data and pregnancy outcomes were compared among women exposed to microbial invasion of the amniotic cavity by Ureaplasma spp., women with microbial invasion of the amniotic cavity by other microorganisms, and a No‐microbial invasion of the amniotic cavity/No‐intra‐amniotic inflammation group. The short‐term neonatal outcome was evaluated in women delivering after 24.0 weeks. Results We included 228 women with preterm labor. Microbial invasion of the amniotic cavity occurred in 35% (80/228), 28% (22/80) being caused by Ureaplasma spp. Gestational age at admission and at delivery were significantly earlier and the rate of delivery at <24.0 weeks' gestation and of women who further developed clinical chorioamnionitis were significantly higher in women with microbial invasion of the amniotic cavity by microorganisms other than Ureaplasma spp. However, after 24 weeks, regardless of the microorganisms isolated, the short‐term neonatal outcome was similar between women exposed to microbial invasion of the amniotic cavity and the No‐microbial invasion of the amniotic cavity/No‐intra‐amniotic inflammation group when gestational age was considered. Conclusions Microbial invasion of the amniotic cavity by microorganisms other than Ureaplasma spp. was associated with earlier gestational age at admission and at delivery, and a higher rate of preterm delivery <24.0 weeks and of women who developed clinical chorioamnionitis. However, we did not find differences in the short‐term neonatal outcome between women exposed to microbial invasion of the amniotic cavity and the no‐microbial invasion of the amniotic cavity/no‐intra‐amniotic inflammation group delivering after 24.0 weeks' gestation when adjusted by gestational age at delivery.