The Role of Ureaplasma urealytkum in Adverse Pregnancy Outcome

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Abstract
EDITORIAL COMMENT: We accepted this paper for publication because it gives important information about the frequency of colonization of the lower and upper genital tract of pregnant women with Ureaplasma urealyticum. Although the authors discuss adverse pregnancy outcome they did not mention perinatal mortality or morbidity due to infection with Ureaplasma urealyticum although they note that there were 4 of the 16 preterm deliveries where there was evidence of chorioamnionitis. We have previously published a paper from the Toowoomba Base Hospital group on Ureaplasma urealyticum chorioamnionitis associated with 2 perinatal deaths and 1 case of severe chorioamnionitis where the infant survived (A). We refer readers to the Editorial Comment that accompanied this paper. Summary: We investigated Ureaplasma urealyticum genital tract colonization rates in an Australian population to determine whether colonization was associated with adverse pregnancy outcome. Women attending an antenatal clinic were evaluated for lower genital tract colonization at their first antenatal visit (162 women) and at 28 weeks' gestation (120 women). Placentas from 92 women were cultured. U. urealyticum was the predominant isolate from the lower (57.4%) and upper (17.4%) genital tract in this population of pregnant women. U. urealyticum was a persistent colonizer during mid‐trimester of pregnancy (in 88% of women colonized) whereas M. hominis, G. vaginalis, and Group B streptococcus were present as transient flora of the lower genital tract. Lower genital tract colonization during pregnancy was not directly associated with adverse pregnancy outcome. However preterm delivery in afebrile, asymptomatic women, could possibly be associated with chorioamnionitis (4 of 16 preterm births). Screening of women with a history of preterm birth may prevent upper genital tract infections and preterm delivery.