Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods

Daniel B. Digiulio, Mariateresa Gervasi, Roberto Romero, Shali Mazaki-Tovi, Edi Vaisbuch, Juan Pedro Kusanovic, Kimberley S. Seok, Ricardo Gómez, Pooja Mittal, Francesca Gotsch, Tinnakorn Chaiworapongsa, Enrique Oyarzun, Chong Jai Kim, David A. Relman

Research output: Contribution to journalArticlepeer-review

60 Scopus citations

Abstract

Objective: Infection has been implicated in the pathogenesis of preeclampsia, yet the association between microbial invasion of the amniotic cavity (MIAC) and preeclampsia has not been determined. The aim of this study was to determine the prevalence, and microbial diversity associated with MIAC, as well as the nature of the host response to MIAC in patients with preeclampsia. Method of study: Amniotic fluid (AF) from 62 subjects with preeclampsia, not in labor, was analyzed with both cultivation and molecular methods. Broad-range and group-specific PCR assays targeting small subunit ribosomal DNA, or other gene sequences, from bacteria, fungi and archaea were used. Results were correlated with measurements of host inflammatory response, including AF white blood cell count and AF concentrations of glucose, interleukin-6 (IL-6) and MMP-8. Results: 1) The rate of MIAC in preeclampsia was 1.6% (1/62) based on cultivation techniques, 8% (5/62) based on PCR, and 9.6% (6/62) based on the combined results of both methods; 2) among the six patients diagnosed with MIAC, three had a positive PCR for Sneathia/Leptotrichia spp.; and 3) patients with MIAC were more likely to have evidence of an inflammatory response in the amniotic cavity than those without MIAC, as determined by a higher median AF IL-6 [1.65 ng/mL interquartile range (IQR): 0.35-4.62 vs. 0.22 ng/mL IQR: 0.12-0.51; P=0.002). Conclusion: The prevalence of MIAC in preeclampsia is low, suggesting that intra-amniotic infection plays only a limited role in preeclampsia. However, the unexpectedly high number of positive AF specimens for Sneathia/Leptotrichia warrants further investigation.

Original languageEnglish
Pages (from-to)503-513
Number of pages11
JournalJournal of Perinatal Medicine
Volume38
Issue number5
DOIs
StatePublished - 1 Sep 2010
Externally publishedYes

Keywords

  • 16S rRNA
  • IL-6
  • PCR
  • Sneathia/Leptotrichia spp.
  • Ureaplasma urealyticum
  • intra-amniotic infection
  • intra-amniotic inflammation
  • preeclampsia
  • pregnancy

Fingerprint

Dive into the research topics of 'Microbial invasion of the amniotic cavity in preeclampsia as assessed by cultivation and sequence-based methods'. Together they form a unique fingerprint.

Cite this