Identification of intracellular bacteria in the basal plate of the human placenta in term and preterm gestations

被引:257
作者
Stout, Molly J. [1 ]
Conlon, Bridget [1 ]
Landeau, Michele [1 ]
Lee, Iris [1 ]
Bower, Carolyn [1 ]
Zhao, Qiuhong [1 ]
Roehl, Kimberly A. [1 ]
Nelson, D. Michael [1 ]
Macones, George A. [1 ]
Mysorekar, Indira U. [1 ,2 ]
机构
[1] Washington Univ, Sch Med, Dept Obstet & Gynecol, St Louis, MO 63110 USA
[2] Washington Univ, Sch Med, Dept Pathol & Immunol, St Louis, MO 63110 USA
基金
美国国家卫生研究院;
关键词
chorioamnionitis; infection; preterm birth; URINARY-TRACT-INFECTION; ESCHERICHIA-COLI; INDICATED PRETERM; PREGNANT-WOMEN; PHYSIOLOGICAL TRANSFORMATION; SPIRAL ARTERIES; AMNIOTIC-FLUID; DELIVERY; FAILURE; CHORIOAMNIONITIS;
D O I
10.1016/j.ajog.2013.01.018
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: Bacteria have been identified in different regions of the placenta. Here, we tested the hypothesis that the maternal basal plate of the placenta harbors microbes that may be associated with adverse pregnancy outcomes. STUDY DESIGN: We performed a cross-sectional study of pregnancies from a single tertiary care hospital. Maternal medical and obstetric characteristics were obtained and pregnancies followed up prospectively for outcomes and placental collection. After delivery, systematic random sampling of the placental basal plate was performed. Paraffin sections of basal plates were stained with 4 histologic stains and scored for morphological evidence of bacteria. RESULTS: Of 195 total patients in the study, Gram-positive and - negative intracellular bacteria of diverse morphologies were documented in the basal plates of 27% of all placentas. Of the patients, 35% delivered preterm. No difference was noted between placental basal plates from preterm or term gestations. Intracellular bacteria were found in the placental basal plates of 54% spontaneous preterm deliveries <28 weeks, and in 26% of term spontaneous deliveries (P = .02). Intracellular bacteria were also documented in placentas without clinical or pathologic chorioamnionitis. CONCLUSION: A total of 27% of placentas demonstrated intracellular bacteria in the placental basal plate using morphological techniques. Thus, the maternal basal plate is a possible source of intrauterine colonization and placental pathological examination could include examination for bacteria in this important maternal-fetal interface.
引用
收藏
页码:226.e1 / 226.e7
页数:7
相关论文
共 41 条
[1]   Recurrence of spontaneous versus medically indicated preterm birth [J].
Ananth, Cande V. ;
Getahun, Darios ;
Peltier, Morgan R. ;
Salihu, Hamisu M. ;
Vintzileos, Anthony M. .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2006, 195 (03) :643-650
[2]   Endometrial microbial colonization and plasma cell endometritis after spontaneous or indicated preterm versus term delivery [J].
Andrews, WW ;
Goldenberg, RL ;
Hauth, JC ;
Cliver, SP ;
Conner, M ;
Goepfert, AR .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2005, 193 (03) :739-745
[3]   RNA signatures allow rapid identification of pathogens and antibiotic susceptibilities [J].
Barczak, Amy K. ;
Gomez, James E. ;
Kaufmann, Benjamin B. ;
Hinson, Ella R. ;
Cosimi, Lisa ;
Borowsky, Mark L. ;
Onderdonk, Andrew B. ;
Stanley, Sarah A. ;
Kaur, Devinder ;
Bryant, Kevin F. ;
Knipe, David M. ;
Sloutsky, Alexander ;
Hung, Deborah T. .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2012, 109 (16) :6217-6222
[4]  
BRAUNER A, 1992, CLIN NEPHROL, V38, P318
[5]   Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. [J].
Carey, JC ;
Klebanoff, MA ;
Hauth, JC ;
Hillier, SL ;
Thom, EA ;
Ernest, JM ;
Heine, RP ;
Nugent, RP ;
Fischer, ML ;
Leveno, KJ ;
Wapner, R ;
Varner, M .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (08) :534-540
[6]   THE REPETITION OF SPONTANEOUS PRETERM LABOR [J].
CARRHILL, RA ;
HALL, MH .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1985, 92 (09) :921-928
[7]   Microbial Prevalence, Diversity and Abundance in Amniotic Fluid During Preterm Labor: A Molecular and Culture-Based Investigation [J].
DiGiulio, Daniel B. ;
Romero, Roberto ;
Amogan, Harold P. ;
Kusanovic, Juan Pedro ;
Bik, Elisabeth M. ;
Gotsch, Francesca ;
Kim, Chong Jai ;
Erez, Offer ;
Edwin, Sam ;
Relman, David A. .
PLOS ONE, 2008, 3 (08)
[8]   BACTERIOLOGY AND ULTRASTRUCTURE OF THE BLADDER IN PATIENTS WITH URINARY-TRACT INFECTIONS [J].
ELLIOTT, TSJ ;
REED, L ;
SLACK, RCB ;
BISHOP, MC .
JOURNAL OF INFECTION, 1985, 11 (03) :191-&
[9]   Maternal Microbe-Specific Modulation of Inflammatory Response in Extremely Low-Gestational-Age Newborns [J].
Fichorova, Raina N. ;
Onderdonk, Andrew B. ;
Yamamoto, Hidemi ;
Delaney, Mary L. ;
DuBois, Andrea M. ;
Allred, Elizabeth ;
Leviton, Alan .
MBIO, 2011, 2 (01)
[10]   VIRULENCE CHARACTERISTICS OF ESCHERICHIA-COLI CAUSING FIRST URINARY-TRACT INFECTION PREDICT RISK OF 2ND INFECTION [J].
FOXMAN, B ;
ZHANG, LX ;
TALLMAN, P ;
PALIN, K ;
RODE, C ;
BLOCH, C ;
GILLESPIE, B ;
MARRS, CF .
JOURNAL OF INFECTIOUS DISEASES, 1995, 172 (06) :1536-1541