Chlamydia trachomatis và viêm nhau thai trong trường hợp sinh non sớm

European Journal of Epidemiology - Tập 26 - Trang 421-428 - 2011
G. Ingrid J. G. Rours1,2, Ronald R. de Krijger3, Alewijn Ott4, Hendrina F. M. Willemse2, Ronald de Groot5, Luc J. I. Zimmermann6, Renee F. Kornelisse7, Henri A. Verbrugh2, Roel P. Verkooijen2
1Department of Paediatric Infectious Disease and Immunology, Erasmus MC, Rotterdam, The Netherlands
2Department of Medical Microbiology and Infectious Diseases, Erasmus MC, Rotterdam, The Netherlands
3Department of Pathology, Josephine Nefkens Institute, Erasmus MC, Rotterdam, The Netherlands
4Laboratory for Infectious Diseases, Groningen, The Netherlands
5Department of Pediatrics, UMC St Radboud, Nijmegen, The Netherlands
6Department of Paediatrics, Maastricht University Hospital, Maastricht, The Netherlands
7Department of Paediatrics, Erasmus MC, Rotterdam, The Netherlands

Tóm tắt

Chlamydia trachomatis có thể lây nhiễm sang nhau thai và từ đó dẫn đến sinh non. Mục tiêu của chúng tôi là đánh giá mối quan hệ giữa sự hiện diện của Chlamydia trachomatis và các dấu hiệu viêm nhau thai ở những phụ nữ sinh ở tuần 32 của thai kỳ hoặc ít hơn. Bối cảnh: Dữ liệu mô học nhau thai và lâm sàng đã được thu thập theo cách triển khai từ 304 phụ nữ và trẻ sơ sinh tại Erasmus MC-Sophia, Rotterdam, Hà Lan. Kiểm tra Chlamydia trachomatis trên nhau thai đã được thực hiện hồi cứu bằng phương pháp PCR. Chlamydia trachomatis đã được phát hiện trong 76 (25%) nhau thai. Bằng chứng mô học về viêm nhau thai có mặt trong 123 (40%) nhau thai: ở 41/76 (54%) nhau thai có Chlamydia trachomatis so với 82/228 (36%) nhau thai không có nhiễm Chlamydia trachomatis (OR 2.1, 95% CI 1.2–3.5). Nhiễm Chlamydia trachomatis tương quan với sự tiến triển (P = 0.009) và cường độ (P = 0.007) của viêm nhau thai mẹ-nhau. DNA của Chlamydia trachomatis thường được phát hiện trong nhau thai của những phụ nữ có sinh non sớm, và có liên quan đến các dấu hiệu giải phẫu bệnh của viêm nhau thai.

Từ khóa

#Chlamydia trachomatis #viêm nhau thai #sinh non #tiến triển viêm #cấp độ viêm

Tài liệu tham khảo

McCormick MC. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985;312(2):82–90. Hillier SL, Martius J, Krohn M, Kiviat N, Holmes KK, Eschenbach DA. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med. 1988;319(15):972–8. Lettieri L, Vintzileos AM, Rodis JF, Albini SM, Salafia CM. Does “idiopathic” preterm labor resulting in preterm birth exist? Am J Obstet Gynecol. 1993;168(5):1480–5. Salafia CM, Vogel CA, Vintzileos AM, Bantham KF, Pezzullo J, Silberman L. Placental pathologic findings in preterm birth. Am J Obstet Gynecol. 1991;165(4 Pt 1):934–8. Watterberg KL, Demers LM, Scott SM, Murphy S. Chorioamnionitis and early lung inflammation in infants in whom bronchopulmonary dysplasia develops. Pediatrics. 1996;97(2):210–5. De Felice C, Toti P, Laurini RN, Stumpo M, Picciolini E, Todros T, et al. Early neonatal brain injury in histologic chorioamnionitis. J Pediatr. 2001;138(1):101–4. Mehta R, Nanjundaswamy S, Shen-Schwarz S, Petrova A. Neonatal morbidity and placental pathology. Indian J Pediatr. 2006;73(1):25–8. Hagberg H, Wennerholm UB, Savman K. Sequelae of chorioamnionitis. Curr Opin Infect Dis. 2002;15(3):301–6. Laar MJW van de, Ossewaarde JM. Sexually transmitted diseases in the Netherlands; update 1996 (in Dutch) Bilthoven: RIVM; report no.: 441500006, 1997. Martin DH, Koutsky L, Eschenbach DA, Daling JR, Alexander ER, Benedetti JK, et al. Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections. JAMA. 1982;247(11):1585–8. Harrison HR, Alexander ER, Weinstein L, Lewis M, Nash M, Sim DA. Cervical Chlamydia trachomatis and mycoplasmal infections in pregnancy. Epidemiology and outcomes. JAMA. 1983;250(13):1721–7. Gravett MG, Nelson HP, DeRouen T, Critchlow C, Eschenbach DA, Holmes KK. Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA. 1986;256(14):1899–903. Sweet RL, Landers DV, Walker C, Schachter J. Chlamydia trachomatis infection and pregnancy outcome. Am J Obstet Gynecol. 1987;156(4):824–33. Martius J, Krohn MA, Hillier SL, Stamm WE, Holmes KK, Eschenbach DA. Relationships of vaginal Lactobacillus species, cervical Chlamydia trachomatis, and bacterial vaginosis to preterm birth. Obstet Gynecol. 1988;71(1):89–95. Association of Chlamydia trachomatis and Mycoplasma hominis with intrauterine growth retardation and preterm delivery. The John Hopkins Study of Cervicitis and Adverse Pregnancy Outcome. Am J Epidemiol. 1989;129(6):1247–57. Ngassa PC, Egbe JA. Maternal genital Chlamydia trachomatis infection and the risk of preterm labor. Int J Gynaecol Obstet. 1994;47(3):241–6. Claman P, Toye B, Peeling RW, Jessamine P, Belcher J. Serologic evidence of Chlamydia trachomatis infection and risk of preterm birth. CMAJ. 1995;153(3):259–62. Gencay M, Koskiniemi M, Ammala P, Fellman V, Narvanen A, Wahlstrom T, et al. Chlamydia trachomatis seropositivity is associated both with stillbirth and preterm delivery. APMIS. 2000;108(9):584–8. Andrews WW, Goldenberg RL, Mercer B, Iams J, Meis P, Moawad A, et al. The Preterm Prediction Study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecol. 2000;183(3):662–8. Karinen L, Pouta A, Bloigu A, Koskela P, Paldanius M, Leinonen M, et al. Serum C-reactive protein and Chlamydia trachomatis antibodies in preterm delivery. Obstet Gynecol. 2005;106(1):73–80. Odendaal HJ, Schoeman J. The association between Chlamydia trachomatis genital infection and spontaneous preterm labour. South Afr J Obstet Gynaecol. 2006;12(3):146–9. Blas MM, Canchihuaman FA, Alva IE, Hawes SE. Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sex Transm Infect. 2007;83(4):314–8. Kataoka S, Yamada T, Chou K, Nishida R, Morikawa M, Minami M, et al. Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy. J Clin Microbiol. 2006;44(1):51–5. Silveira MF, Ghanem KG, Erbelding EJ, Burke AE, Johnson HL, Singh RH, et al. Chlamydia trachomatis infection during pregnancy and the risk of preterm birth: a case-control study. Int J STD AIDS. 2009;20(7):465–9. Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy. 2001;20(1):IX–XIV. Giedion A, Haefliger H, Dangel P. Acute pulmonary X-ray changes in hyaline membrane disease treated with artificial ventilation and positive end-expiratory pressure (PEP). Pediatr Radiol. 1973;1(3):145–52. Volpe JJ. Hypoxic-ischemic encephalopathy: clinical aspects. In: Volpe JJ, ed Neurology of the newborn Philadelphia: Saunders; 2001:331–94. 2001. Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, et al. Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Ann Surg. 1978;187(1):1–7. Redline RW, Faye-Petersen O, Heller D, Qureshi F, Savell V, Vogler C. Amniotic infection syndrome: nosology and reproducibility of placental reaction patterns. Pediatr Dev Pathol. 2003;6(5):435–48. Lan J, Ossewaarde JM, Walboomers JM, Meijer CJ, van den Brule AJ. Improved PCR sensitivity for direct genotyping of Chlamydia trachomatis serovars by using a nested PCR. J Clin Microbiol. 1994;32(2):528–30. Gencay M, Puolakkainen M, Wahlstrom T, Ammala P, Mannonen L, Vaheri A, et al. Chlamydia trachomatis detected in human placenta. J Clin Pathol. 1997;50(10):852–5. Dong ZW, Li Y, Zhang LY, Liu RM. Detection of Chlamydia trachomatis intrauterine infection using polymerase chain reaction on chorionic villi. Int J Gynaecol Obstet. 1998;61(1):29–32. Matovina M, Husnjak K, Milutin N, Ciglar S, Grce M. Possible role of bacterial and viral infections in miscarriages. Fertil Steril. 2004;81(3):662–9. Rours GIJG. Chlamydia trachomatis infections during pregnancy: consequences for pregnancy outcome and infants. Medical Science [thesis]. Rotterdam: Erasmus University; 2010; 87–104. Pankuch GA, Appelbaum PC, Lorenz RP, Botti JJ, Schachter J, Naeye RL. Placental microbiology and histology and the pathogenesis of chorioamnionitis. Obstet Gynecol. 1984;64(6):802–6. Romero R, Salafia CM, Athanassiadis AP, Hanaoka S, Mazor M, Sepulveda W, et al. The relationship between acute inflammatory lesions of the preterm placenta and amniotic fluid microbiology. Am J Obstet Gynecol. 1992;166(5):1382–8. Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. N Engl J Med. 2000;342(20):1500–7. Shariat H, Young M, Abedin M. An interesting case presentation: a possible new route for perinatal acquisition of Chlamydia. J Perinatol. 1992;12(3):300–2. Bell TA. Chlamydia trachomatis infection in dizygotic twins delivered by caesarean section. Genitourin Med. 1988;64(5):347–8. La Scolea LJ Jr, Paroski JS, Burzynski L, Faden HS. Chlamydia trachomatis infection in infants delivered by cesarean section. Clin Pediatr (Phila). 1984;23(2):118–20. Givner LB, Rennels MB, Woodward CL, Huang SW. Chlamydia trachomatis infection in infant delivered by cesarean section. Pediatrics. 1981;68(3):420–1.