Aim To investigate a correlation between cervical canal infection and imminent preterm labor and to identify most frequent pathogens. Methods A prospective study was conducted in obstetrics/gynecology departments of Health Center and the University Clinical Center Tuzla, and General Hospital Tešanj (Bosnia and Herzegovina, B&H) between October 2013 and May 2014. An examined group included 50 healthy pregnant women with singleton pregnancy of the gestation age between the 28th and 37th week, with cervical changes that are related to imminent preterm labor. Changes were detected by ultrasound biometry of cervix and modified Bishop score. A control group included 30 healthy pregnant women with singleton pregnancy of the gestation age between the 28th and 37th week of pregnancy without signs of imminent preterm labor. Cervical mucus was microbiologically analyzed for identification of pathogens. Results The infection in cervical canal was proven in 35 (70%) examinees and four (13%) patients from the control group (p=0.015). In seven (20%) cases each Ureaplasma and Mycoplasma were detected followed by E. coli in five (14%) cases (p=0.001). Conclusion Cervical canal infection is associated with changes on cervix and premature rupture of fetal membranes, i.e. preterm labor and imminent preterm labor. Screening for infection before pregnancy should be the main task of family doctors as well as gynecologists.
Araújo B, Zatti H, Madi J, Coelho M. Olmi FB; Canabarro CT. Analysis of neonatal morbidity and mortality in late-preterm newborn infants. J Pediatr. 2012. p. 259–66.
2.
Beck S, Wojdyla D, Say L, Betran A, Merialdi M, Requejo J, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010. p. 31–8.
3.
Fox C, Eichelberger K. Maternal microbiome and pregnancy outcomes. Fertil Steril. 2015. p. 1358–63.
4.
Schleußner E The prevention, diagnosis and treatment of premature labor. Dtsch Arztebl Int. 2013. p. 227–35.
5.
Martin J, Hamilton B, Sutton P, Martin J, Hamilton B, Sutton P, et al. Births: final data for 2007. Nat Vital Stat Rep. 2010. p. 1–85.
6.
Lamont R. Infection in the prediction and antibiotics in the prevention of spontaneous preterm labour and preterm birth. BJOG. 2003. p. 71–5.
7.
Romero R, Sirtori M, Oyarzun E, Avila C, Mazor M, Calahan R, et al. Prevalence, microbiology, and clinical significance of intraamniotic infection in women with preterm labor and intact membranes. Infect Labor. 1981. p. 817–24.
8.
Agrawal V, Hirsch E. Intrauterine infection and preterm labor. Semin Fetal Neonatal Med. 2012. p. 12–9.
9.
Subramaniam A, Lees B, Becker D, Tang Y, Khan M, Edwards R. Evaluation of human papilloma virus as a risk factor for preterm birth or pregnancy-related hypertension. Obstet Gynecol. 2016. p. 233–40.
10.
Knop J, Penick E, Jensen P, Nickel E, Gabrielli W, Mednick S, et al. Risk factors that predicted problem drinking in Danish men at age thirty. J Stud Alcohol. 2003. p. 745–55.
11.
Haram K, Mortensen J, Wollen A. Preterm delivery: an overview. Acta Obstet Gynecol Scand. 2003. p. 687–704.
12.
World Health Organization. The incidence of low birth weight: A critical review of available information. WHO; 1980. p. 197–203.
13.
Cram L, Zapata M, Toy E, Baker B. Genitourinary infections and their association with preterm labor. Am Fam Physician. 2002. p. 241–8.
14.
Verma I, Avasthi K, Berry V. Urogenital Infections as a risk factor for preterm labor: A hospital-based case-control study. J Obstet Gynaecol India. 2014. p. 274–8.
15.
Marai W. Lower genital tract infections among pregnant women: a review. East Afr Med J. 2001. p. 581–5.
16.
Antony K, Ma J, Mitchell K, Racusin D, Versalovic J, Aagaard K. The preterm placental microbiome varies in association with excess maternal gestational weight gain. Am J Obstet Gynecol. 2015. p. 653-e654.
17.
Mysorekar I, Cao B. Microbiome in parturition and preterm birth. Semin Reprod Med. 2014. p. 50–5.
18.
Jiang L, Yan Q, Liu R, Zhang L. Preventive and therapeutic effect of N-Acetyl-l-cysteine on infection-associated preterm labor in mice. Asian Pac J Trop Med. 2016. p. 197–200.
19.
Locksmith G, Duff P. Infection, antibiotics, and preterm delivery. Semin Perinatol. 2001. p. 295–309.
20.
Oh K, Lee K, Sohn Y, Park C, Hong J, Romero R, et al. Intraamniotic infection with genital mycoplasmas exhibits a more intense inflammatory response than intraamniotic infection with other microorganisms in patients with preterm premature rupture of membranes. Am J Obstet Gynecol. 2010. p. 211.
21.
Averbach H, Hacker M, Yiu T, Modest A, Dimitrakoff J, Ricciotti A. Mycoplasma genitalium and preterm delivery at an urban community health center. Int J Gynaecol Obstet. 2013. p. 54–7.
22.
Bjartling C, Osser S, Persson K. Mycoplasma genitalium in cervicitis and pelvic inflammatory disease among women at a gynecologic outpatient service. Am J Obstet Gynecol. 2012. p. 476-e477.
23.
Waites K, Katz B, Schelonka R. Mycoplasmas and Ureaplasmas as neonatal pathogens. Clin Microbiol Rev. 2005. p. 757–89.
24.
Viscardi R. Ureaplasma species: Role in diseases of prematurity. Clin Perinatol. 2010. p. 393–409.
25.
Sung T. Ureaplasma infections in pre-term infants: Recent information regarding the role of Ureaplasma species as neonatal pathogens. Korean J Pediatr. 2010. p. 989–93.
26.
Krohn M, Thwin S, Rabe L, Brown Z, Hillier S. See comment in PubMed Commons belowVaginal colonization by Escherichia coli as a risk factor for very low birth weight delivery and other perinatal complications. J Infect Dis. 1997. p. 606–10.
27.
Kwak D, Hwang H, Kwon J, Park Y, Kim Y. Co-infection with vaginal Ureaplasma urealyticum and Mycoplasma hominis increases adverse pregnancy outcomes in patients with preterm labor or preterm premature rupture of membranes. J Matern Fetal Neonatal Med. 2014. p. 333–7.
28.
Koumans E, Sternberg M, Bruce C, Mcquillan G, Kendrick J, Sutton M, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007. p. 864–9.
29.
Rasa T. Escherichia coli colonization in neonates: prevalence, perinatal transmission, antimicrobial susceptibility, and risk factors. Medicina. 2012. p. 71–6.
30.
Krashin J, Koumans E, Bradshaw-Sydnor A, Braxton J, Secor E, Sawyer W, et al. Trichomonas vaginalis prevalence, incidence, risk factors and antibiotic-resistance in an adolescent population. Sex Transm Dis. 2010. p. 440–4.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.