Oral and uro-vaginal intra-amniotic infection in women with preterm delivery: A case-control study.

Abstract

The aim of the present study was to establish the association between the presence of oral and uro-vaginal microorganisms in the placental membrane and preterm delivery (PTD), the premature rupture of membranes (PRM), and the clinical signs of intra-amniotic infection. Eighty-four women with PTD and 127 women with delivery at term were assessed for the PRM, clinical signs of intra-amniotic infection, and the presence of periodontitis. Twenty-seven microorganisms were identified in the placental tissue using nested polymerase chain reaction (PCR). Porphyromonas gingivalis (P.gingivalis) was quantified by droplet digital PCR. The prevalence of microorganisms was 9.47% (20/211). P.gingivalis was the most prevalent (12/211, 5.68%). Mycoplasma hominis, Ureaplasma urealyticum, Staphylococcus spp, and Fusobacterium nucleatum were isolated at a very low frequency in the placenta. Candida albicans was associated with PTD (P=0.027). Periodontitis was associated with clinical signs of infection (odds ratio [OR]=3.8, 95% confidence interval [CI]: 1.28-13.5) and with PTD (OR=1.99; 95% CI: 1.07-3.72). The presence of P.gingivalis in the placenta was not associated with perinatal complications. Detecting microorganisms in the placenta by nested PCR is not relevant, as it has a poor association with clinical variables that establish the diagnosis of chorioamnionitis. However, periodontitis was associated with the clinical signs of intra-amniotic infection and PTD.