The role of genital tract infection inpreterm delivery: aretrospective study

https://doi.org/10.19106/JMedSci005103201904

Yohanes Aditya Adhi Satria(1*), Uki Retno Budihastuti(2), Tri Nugraha Susilawati(3)

(1) Undergraduate Program in Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
(2) Department of Obstetric and Gynecology, Dr Moewardi General Hospital/Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
(3) Department of Microbiology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
(*) Corresponding Author

Abstract


 

Preterm delivery is associated with higher mortality and morbidity of neonates, also increasestheir risk of having growth and development impairment.This study aimed toidentify the role ofgenital tract infection in preterm delivery. A retrospective study was conducted on medical records of mothers who had preterm delivery in a tertiary hospital in Surakarta, Indonesia during 2017. The data collected were mothers’ age and their gestational age, the history of current pregnancy, the number of previous abortion(s), mothers’ body temperature, the extent of abnormal vaginal discharge, and laboratory findings (white blood cell count, platelet count, red blood cell count, hemoglobin count, hematocrit level, urinalysis and microbiology results). The statistical differences amongst categorical and numerical data were analyzed using the Chi-Square test and the Mann-Whitney test. Based on the patient’s history and the examination results, we suspected genital tract infections in22.52% (25/111)of subjects. All of them had abnormal vaginal discharge despite only one case had been confirmed as streptococcal infection. This study found that the majority of mothers with probable genital tract infection hadpreterm premature rupture of the membrane whilst preeclampsiawas more evident in those without genital tract infection. We conclude that genital tract infection during pregnancy is a significant contributor to the occurence of premature birth so that microbiological testing is needed to confirm the diagnosis.


Keywords


pregnancy; preterm delivery; premature birth; premature rupture of membrane; genital tract infection

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References

  1. World Health Organization. Preterm birth. WHO Publication 2018. [cited from]: https://www.who.int/news-room/fact-sheets/detail/preterm-birth
  2. Katz J, Lee ACC, Kozuki N, Lawn JE, Cousens S, Blencowe H, Ezzati M, et al. Mortality risk in preterm and small-for-gestational-age infants in low-income and middle-income countries: A pooled country analysis. Lancet 2013; 382(9890):417-25. https://doi.org/10.1016/S0140-6736(13)60993-9
  3. Chandra I, Sun L. Third trimester preterm and term premature rupture of membranes: is there any difference in maternal characteristics and pregnancy outcomes? J Chin Med Assoc 2017; 80(10):657-61. https://doi.org/10.1016/j.jcma.2016.12.006
  4. Verma I, Avasthi K, Berry V. Urogenital infections as a risk factor for preterm labor: a hospital-based case-control study. J Obstet Gynecol India 2014; 64(4):274-8. https://doi.org/10.1007/s13224-014-0523-6
  5. Alijahan R, Hazrati S, Mirzarahimi M, Pourfarzi F, Hadi PA. Prevalence and risk factors associated with preterm birth in Ardabil, Iran. Iran J Reprod Med 2014; 12(1):47-56.
  6. Knowles SJ, O’Sullivan NP, Meenan AM, Hanniffy R, Robson M. Maternal sepsis incidence, aetiology and outcome for mother and fetus: A prospective study. BJOG 2015; 122(5):663-71. https://doi.org/10.1111/1471-0528.12892
  7. Nadeau HC, Subramaniam A, Andrews WW. Infection and preterm birth. Semin Fetal Neonatal Med 2016; 21(2):100-5. https://doi.org/10.1016/j.siny.2015.12.008
  8. Gomez-Lopez N, StLouis D, Lehr MA, Sanchez-Rodriguez EN, Arenas-Hernandez M. Immune cells in term and preterm labor. Cell Mol Immunol 2014; 11(6):571-81. https://doi.org/10.1038/cmi.2014.46
  9. American Congress of Obstetricians and Gynecologists’ Committee on Practice Bulletins– Obstetrics. Practice Bulletin No. 172: premature rupture of membranes. Obstet Gynecol 2016; 128(4):e165-77. https://doi.org/10.1097/AOG.0000000000001712
  10. Brkičević E, Grgić G, Ljuca D, Ostrvica E, Tulumović A. Etiological factors of preterm delivery. JHSci 2013; 3(2):159-63. https://doi.org/10.17532/jhsci.2013.81
  11. Frey HA, Klebanoff MA. The epidemiology, etiology, and costs of preterm birth. Semin Fetal Neonatal Med 2016; 21(2):68-73. https://doi.org/10.1016/j.siny.2015.12.011
  12. Hamza A, Herr D, Solomayer EF, Meyberg - Solomayer G. Polyhydramnios: causes, diagnosis and therapy. Geburtshilfe Frauenheilkd 2013; 73(12):1241-6. https://doi.org/10.1055/s-0033-1360163
  13. Romero R, Dey SK, Fisher SJ. Preterm labor: one syndrome, many causes. Science 2014; 345(6198):760-65. https://doi.org/10.1126/science.1251816
  14. Boyle AK, Rinaldi SF, Norman JE, Stock SJ. Preterm birth: inflammation, fetal injury and treatment strategies. J Reprod Immunol 2017; 119:62-6. https://doi.org/10.1016/j.jri.2016.11.008
  15. Auger N, Le TU, Park AL, Luo ZC. Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study. BMC Pregnancy Childbirth 2011; 11(67):1-10. https://doi.org/10.1186/1471-2393-11-67
  16. Roozbeh N, Moradi S, Soltani S, Zolfizadeh F, Hasani MT, Yabandeh AP. Factors associated with preterm labor in Hormozgan province in 2013. Electron Physician 2016; 8(9):2918-23. https://doi.org/10.19082/2918
  17. Badan Pusat Statistika (BPS) Jawa Tengah. Population and population growth rate by regency/municipality in Jawa Tengah Province, 2015, 2016, and 2017. 2018 [cited from]: https://jateng.bps.go.id/statictable/2017/10/26/1533/jumlah-penduduk-dan-laju-pertumbuhan-penduduk-menurut-kabupaten-kota-di-provinsi-jawa-tengah-2015-2017.html
  18. Nakubulwa S, Kaye DK, Bwanga F, Tumwesigye NM, Mirembe FM. Genital infections and risk of premature rupture of membranes in Mulago Hospital, Uganda: a case control study. BMC Res Notes 2015; 8:573. https://doi.org/10.1186/s13104-015-1545-6
  19. Tellapragada C, Eshwara VK, Bhat P, Kamath A, Aletty S, Mukhopadhyay C. Screening of vulvovaginal infections during pregnancy in resource constrained settings: Implications on preterm delivery. J Infect Public Health 2017; 10(4):431-7. https://doi.org/10.1016/j.jiph.2016.06.003
  20. Verma A, Kumar Meena J, Banerjee B. A comparative study of prevalence of RTI/STI symptoms and treatment seeking behaviour among the married women in urban and rural areas of Delhi. Int J Reprod Med 2015; 2015:563031. https://doi.org/10.1155/2015/563031
  21. Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am J Obstet Gynecol 2013; 209(6):505-23. https://doi.org/10.1016/j.ajog.2013.05.006
  22. Bongomin F, Gago S, Oladele RO, Denning DW. Global and multi-national prevalence of fungal diseases-estimate precision. J Fungi (Basel) 2017; 3(4):57. https://doi.org/10.3390/jof3040057
  23. Casillas-Vega N, Morfïn-Otero R, Garcïa S, Camacho-Ortiz A, Garza-Gonzïlez E. Causative agents, diseases, epidemiology and diagnosis of sexually transmitted infections. Rev Med Microbiol 2017; 28(1):9-18. https://doi.org/10.1097/MRM.0000000000000089
  24. World Health Organization. Sexually transmitted infections (STIs). 2016. [cited from]: https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)
  25. Hamedi A, Akhlaghi F, Seyedi SJ, Kharazmi A. Evaluation of group B streptococci colonization rate in pregnant women and their newborn. Acta Med Iran 2012; 50(12):805-8.
  26. Melo SCCS, Costa AB, Silva FTRD, Silva NMMG, Tashima CM, Cardoso RF, et al. Prevalence of Streptococcus agalactiae colonization in pregnant women from the 18th Health Region of Paraná State. Rev Inst Med Trop Sao Paulo 2018; 60:e2. https://doi.org/10.1590/s1678-9946201860002
  27. da Fonseca TM, Cesar JA, Mendoza-Sassi RA, Schmidt EB. Pathological vaginal discharge among pregnant women : pattern of occurrence and association in a population-based survey. Obstet Gynecol Int 2013; 2013:590416. https://doi.org/10.1155/2013/590416
  28. Kumar D, Moore RM, Mercer BM, Mansour JM, Redline RW, Moore JJ. The physiology of fetal membrane weakening and rupture: Insights gained from the determination of physical properties revisited. Placenta 2016; 42:59-73. https://doi.org/10.1016/j.placenta.2016.03.015
  29. Keelan JA. Intrauterine inflammatory activation, functional progesterone withdrawal, and the timing of term and preterm birth. J Reprod Immunol 2018; 125:89-99. https://doi.org/10.1016/j.jri.2017.12.004
  30. Chan GJ, Lee AC, Baqui AH, Tan J, Black RE. Risk of early-onset neonatal infection with maternal infection or colonization: a global systematic review and meta-analysis. PLoS Med. 2013; 10(8):e1001502. https://doi.org/10.1371/journal.pmed.1001502
  31. Simonsen KA, Anderson-Berry AL, Delair SF, Davies HD. Early-onset neonatal sepsis. Clin Microbiol Rev 2014; 27(1):21-47. https://doi.org/ 10.1128/CMR.00031-13
  32. Shane AL, Sánchez PJ, Stoll BJ. Neonatal sepsis. Lancet 2017; 390(10104):1770-80. https://doi.org/10.1016/S0140-6736(17)31002-4
  33. Shah BA, Padbury JF. Neonatal sepsis: an old problem with new insights. Virulence 2014; 5(1):170-8. https://doi.org/10.4161/viru.26906
  34. Anonymous. ACOG Practice Bulletin No. 202: Gestational hypertension and preeclampsia. Obstet Gynecol 2019; 133(1):e1-e25. https://doi.org/10.1097/AOG.0000000000003018
  35. Scharfe-Nugent A, Corr SC, Carpenter SB, Keogh L, Doyle B, Martin C, et al. TLR9 provokes inflammation in response to fetal DNA: mechanism for fetal loss in preterm birth and preeclampsia. J Immunol 2012; 188(11):5706-12. https://doi.org10.4049/jimmunol.1103454



DOI: https://doi.org/10.19106/JMedSci005103201904

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