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Differing Prevalence and Diversity of Bacterial Species in Fetal Membranes from Very Preterm and Term Labor

Jones, HE; Harris, KA; Azizia, M; Bank, L; Carpenter, B; Hartley, JC; Klein, N; (2009) Differing Prevalence and Diversity of Bacterial Species in Fetal Membranes from Very Preterm and Term Labor. PLOS ONE , 4 (12) , Article e8205. 10.1371/journal.pone.0008205. Green open access

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Abstract

Background: Intrauterine infection may play a role in preterm delivery due to spontaneous preterm labor (PTL) and preterm prolonged rupture of membranes (PPROM). Because bacteria previously associated with preterm delivery are often difficult to culture, a molecular biology approach was used to identify bacterial DNA in placenta and fetal membranes.Methodology/Principal findings: We used broad-range 16S rDNA PCR and species-specific, real-time assays to amplify bacterial DNA from fetal membranes and placenta. 74 women were recruited to the following groups: PPROM,32 weeks (n = 26; 11 caesarean); PTL with intact membranes,32 weeks ( n = 19; all vaginal birth); indicated preterm delivery,32 weeks ( n = 8; all caesarean); term ( n = 21; 11 caesarean). 50% (5/10) of term vaginal deliveries were positive for bacterial DNA. However, little spread was observed through tissues and species diversity was restricted. Minimal bacteria were detected in term elective section or indicated preterm deliveries. Bacterial prevalence was significantly increased in samples from PTL with intact membranes [89% (17/19) versus 50% (5/10) in term vaginal delivery p = 0.03] and PPROM ( CS) [55% (6/11) versus 0% (0/11) in term elective CS, p = 0.01]. In addition, bacterial spread and diversity was greater in the preterm groups with 68% (13/19) PTL group having 3 or more positive samples and over 60% (12/19) showing two or more bacterial species ( versus 20% (2/10) in term vaginal deliveries). Blood monocytes from women with PTL with intact membranes and PPROM who were 16S bacterial positive showed greater level of immune paresis ( p = 0.03). A positive PCR result was associated with histological chorioamnionitis in preterm deliveries.Conclusion/Significance: Bacteria are found in both preterm and term fetal membranes. A greater spread and diversity of bacterial species were found in tissues of women who had very preterm births. It is unclear to what extent the greater bacterial prevalence observed in all vaginal delivery groups reflects bacterial contamination or colonization of membranes during labor. Bacteria positive preterm tissues are associated with histological chorioamnionitis and a pronounced maternal immune paresis.

Type: Article
Title: Differing Prevalence and Diversity of Bacterial Species in Fetal Membranes from Very Preterm and Term Labor
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0008205
Publisher version: http://dx.doi.org/10.1371/journal.pone.0008205
Language: English
Additional information: © 2009 Jones et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. This work was funded by project grant 06UCL01 from SPARKS (Sport Aiding medical Research for Kids, www.SPARKS.org.UK) charity. The study was undertaken at University College London Hospital/University College London and Great Ormond Street Hospital Microbiology Department. University College London Hospital/University College London received a proportion of funding from the Department of Health NIHR Biomedical Research Centres funding scheme. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Keywords: CORTICOTROPIN-RELEASING HORMONE, POLYMERASE-CHAIN-REACTION, TOLL-LIKE RECEPTORS, REAL-TIME PCR, UREAPLASMA-UREALYTICUM, INTRAUTERINE INFECTION, MONOCYTE DEACTIVATION, PREMATURE RUPTURE, AMNIOTIC-FLUID, BIRTH
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Maternal and Fetal Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/106331
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