Background
Ureaplasma species (spp) are the bacteria most often isolated from the amniotic cavity of women with preterm
labor or preterm premature rupture of membranes; thus, the link between intrauterine
Ureaplasma spp infection and adverse pregnancy outcome clearly is established. However, because
vaginal Ureaplasma spp colonization is very common in pregnant women, the reason that these microorganisms
cause ascending infections in some cases but remain asymptomatic in most pregnancies
is not clear. Previous studies suggested an association between vaginal colonization
with Ureaplasma parvum as opposed to U urealyticum and preterm delivery. However, because of the high frequency of vaginal Ureaplasma spp colonization during pregnancy, additional risk factors are needed to select a group
of women who might benefit from treatment.
Objective
To further identify pregnant women who are at increased risk for preterm delivery,
the aim of the present study was to investigate U parvum serovar–specific pathogenicity in a large clinical cohort.
Study Design
We serotyped 1316 samples that were positive for U parvum using a high-resolution melt polymerase chain reaction assay, and results were correlated
with pregnancy outcome.
Results
Within U parvum positive samples, serovar 3 was the most common isolate (43.3%), followed by serovar
6 (31.4%) and serovar 1 (25.2%). There was a significantly increased risk for spontaneous
preterm birth at very low (<32 weeks gestation; P<.005) and extremely low (<28 weeks gestation; P<.005) gestational age in the group with vaginal U parvum serovar 3 colonization compared with the control group of pregnant women who tested
negative for vaginal Ureaplasma spp colonization. This association was found for neither serovar 1 nor serovar 6. The
combination of vaginal U parvum serovar 3 colonization and diagnosis of bacterial vaginosis in early pregnancy or
a history of preterm birth further increased the risk for adverse pregnancy outcome.
Conclusion
Colonization with U parvum serovar 3, but not serovar 1 or serovar 6, in early pregnancy is associated with
preterm delivery at very and extremely low gestational age. The combination of U parvum serovar 3 colonization and a history of preterm birth or bacterial vaginosis further
increases the risk for spontaneous preterm birth at low gestational age and may define
a target group for therapeutic intervention studies.
Key words
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Article info
Publication history
Published online: February 05, 2019
Accepted:
January 30,
2019
Received in revised form:
January 25,
2019
Received:
November 23,
2018
Footnotes
Supported, in part, by the “Verein Unser Kind.”
The authors report no conflict of interest.
Cite this article as: Rittenschober-Böhm J, Waldhoer T, Schulz SM, et al. Vaginal Ureaplasma parvum serovars and spontaneous preterm birth. Am J Obstet Gynecol 2019;220:594.e1-9.
Identification
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