Bacterial Infections in Premature Babies More Common Than Previously Realized
Study Shows One in Four Born with Fetal Bacteremia
New York, January 7, 2008 – Premature babies are subject to a host of threats that can result in fetal/neonatal disease. In a study published in the January 2008 issue of the American Journal of Obstetrics & Gynecology, researchers from the University of Alabama–Birmingham Medical School and the Drexel University College of Medicine found that genital mycoplasmas are a frequent cause of congenital fetal infection. 23% of neonates born between 23 and 32 weeks of gestation have positive umbilical blood cultures for two genital mycoplasmas (bacteria lacking cell walls): Ureaplasma urealyticum and Mycoplasma hominis.
Although Ureaplasma urealyticum and Mycoplasma hominis are found in 80% of vaginal and cervical fluids, infants are not generally screened for these bacterial infections. The finding that about one-quarter of early preterm infants is already infected at birth is important in reducing adverse outcomes. These newborns had a higher incidence of neonatal systemic inflammatory response syndrome (SIRS), higher incidence of bronchopulmonary dysplasia (BPD), higher serum concentrations of interleukin (IL)-6 and more evidence of placental inflammation than those with negative cultures. The earlier the gestational age at delivery, the higher the rate of a positive umbilical cord blood culture.
The data, derived from the Alabama Preterm Birth Study, included 457 consecutive singleton deliveries of infants born at 23-32 weeks’ gestation from 1996 to 2001. This study focuses on a subset of 351 women/infant pairs in the population who had umbilical cord blood cultures for U. urealyticum and M. hominis.
Writing in the article, Robert Goldenberg, M.D., Professor, Department of Obstetrics and Gynecology, Drexel University College of Medicine, states, “Given the frequency of these infections and their association with SIRS and likely with BPD, it seems reasonable to determine if infants in these categories would benefit from routine culture for Ureaplasma urealyticum and/or Mycoplasma hominis and subsequent treatment with an antibiotic effective against these organisms. Similarly, we question whether treatment of women likely to deliver an early gestational age infant with an antibiotic effective against these organisms might reduce subsequent neonatal morbidity and mortality.”’
In an accompanying editorial, Roberto Romero, MD, Chief of the Perinatology Research Branch and Program Director for Obstetrics and Perinatology at NICHD/NIH; Professor of Molecular Obstetrics and Genetics, Center of Molecular Medicine, Wayne State University, and Thomas J. Garite, MD, Professor Emeritus, Department of Obstetrics and Gynecology, University of California, Irvine, comment that the article “provides compelling evidence that congenital fetal infection is more frequent than previously realized. The detection of genital mycoplasmas is not part of routine clinical practice in obstetrics and neonatology. Similarly, standard treatment for suspected neonatal sepsis does not include antibiotics effective against these microorganisms.”
Romero and Garite further state that, “The initial uncertainties of whether genital mycoplasmas can cause fetal/neonatal disease are disappearing in light of the accumulating evidence that these microorganisms have been implicated in neonatal sepsis, pneumonia, meningitis and brain damage. Moreover, colonization of the neonatal respiratory tract with these organisms is a risk factor for chronic lung disease.”
The article is “The Alabama Preterm Birth Study: Umbilical Cord Blood Ureaplasma urealyticum and Mycoplasma hominis Cultures in Very Preterm Newborns” by Robert L Goldenberg, MD; William W Andrews, Ph.D., MD; Alice R Goepfert, MD; Ona Faye-Petersen, MD; Suzanne P Cliver; Waldemar A Carlo, MD; and John C Hauth, MD. The editorial is “Twenty Percent of Very Preterm Neonates (23 to 32 weeks) are Born with Bacteremia due to Genital Mycoplasmas” by Roberto Romero and Thomas J. Garite. Both appear in the American Journal of Obstetrics & Gynecology, Volume 198, Issue 1 (January 2008) published by Elsevier.
# # #
Full text of the article and editorial mentioned above is available upon request. Contact Pamela Poppalardo, at (212) 633-3944 or firstname.lastname@example.org to obtain copies. They may also be accessed online at http://www.ajog.org/article/PIIS000293780700912X/fulltext and http://www.ajog.org/article/PIIS0002937807021850/fulltext.
To schedule an interview with Dr. Goldenberg, please call (215) 762 2914 or email email@example.com. To schedule an interview with Dr. Romero, please call (313) 993-2700 or email firstname.lastname@example.org or Dr. Garite, please call (970) 736-2621 or email email@example.com.
About The American Journal of Obstetrics & Gynecology
The American Journal of Obstetrics & Gynecology, known as “The Gray Journal,” presents coverage of the entire spectrum of the field, from the newest diagnostic procedures to leading-edge research. The Journal provides comprehensive coverage of the specialty, including maternal-fetal medicine, reproductive endocrinology/infertility, and gynecologic oncology. It also publishes the annual meeting papers of several of its more than 30 sponsoring societies, including the Society for Maternal-Fetal Medicine and the Society of Gynecologic Surgeons. The American Journal of Obstetrics & Gynecology has the highest ranking for citation frequency of any ob/gyn journal and ranks in the top 1.7% of the 5,684 journals listed in the most recent Science Citation Index.
Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and 25,000 book titles, including major reference works from Mosby and Saunders. Elsevier’s online solutions include ScienceDirect, Scopus, SciVal, Reaxys, ClinicalKey and Mosby’s Suite, which enhance the productivity of science and health professionals, helping research and health care institutions deliver better outcomes more cost-effectively.
A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
+1 212 633 3944