Microbial invasion of the amniotic cavity in pregnancies with small-for-gestational-age fetuses

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

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Objective: Microbial invasion of the amniotic cavity (MIAC) has been detected in women with preterm labor, preterm prelabor rupture of membranes (PROM), and in patients at term with PROM or in spontaneous labor. Intrauterine infection is recognized as a potential cause of fetal growth restriction; yet, the frequency of MIAC in pregnancies with small-for-gestational-age (SGA) fetuses is unknown. The aim of this study was to determine the frequency, diversity and relative abundance of microbes in amniotic fluid (AF) of women with an SGA neonate using a combination of culture and molecular methods. Method: AF from 52 subjects with an SGA neonate was analyzed with both cultivation and molecular methods in a retrospective cohort study. Broad-range and group-specific PCR assays targeted small subunit rDNA, or other gene sequences, from bacteria, fungi and archaea. Results of microbiologic studies were correlated with indices of the host inflammatory response. Results: 1) All AF samples (n=52) were negative for microorganisms based on cultivation techniques, whereas 6% (3/52) were positive based on PCR; and 2) intra-amniotic inflammation was detected in one of the three patients with a positive PCR result, as compared with three patients (6.1%) of the 49 with both a negative culture and a negative PCR (P=0.2). Conclusion: MIAC is detected by PCR in some patients with an SGA fetus who were not in labor at the time of AF collection.
Original languageAmerican English
Pages (from-to)495-502
Number of pages8
JournalJournal of Perinatal Medicine
Volume38
Issue number5
DOIs
StatePublished - 1 Sep 2010
Externally publishedYes

Keywords

  • 16S rRNA
  • chorioamnionitis
  • cytokines
  • FIRS
  • IL-6
  • intra-amniotic infection
  • intra-amniotic inflammation
  • molecular microbiology
  • PCR
  • pregnancy
  • SGA

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