The role of ureaplasmas in the development of preterm birth: renewed discussion in light of new data

DOI

https://dx.doi.org/10.18565/aig.2023.141

Shipitsyna E.V., Pachulia O.V., Bespalova O.N., Kogan I.Yu.
D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology, St. Petersburg, Russia

Intraamniotic infection (IAI) plays a significant role in the development of preterm birth and other pregnancy complications, including premature rupture of membranes, cervical insufficiency, and clinical chorioamnionitis. Ureaplasma is the most common microorganism found in the amniotic cavity of women with IAI. In recent years, there has been a renewed discussion regarding the eradication of ureaplasmas to prevent pregnancy complications associated with IAI, fueled by new data from experimental and clinical studies implicating ureaplasma as an etiological factor. Furthermore, the inclusion of drugs with anti-ureaplasma activity and good placental penetration in treatment regimens for IAI-related pregnancy complications has been shown to improve perinatal outcomes. This review provides an analysis of recent studies on the role of ureaplasmas in triggering preterm birth and other pregnancy complications. This review summarizes findings from meta-analyses of the association between commensal mycoplasmas and adverse perinatal outcomes, and examines data from experimental and clinical studies on the pathogenesis and treatment of ureaplasma-associated IAI. Сonclusion: A substantial body of experimental and clinical evidence supports the involvement of ureaplasmas in the development of IAI. However, it is evident that several factors are necessary for ureaplasmas to exert their pathogenic potential, and identifying these factors is important. Currently, neither species/serotype, high bacterial load, nor specific virulence factors of ureaplasmas can serve as prognostic markers for an unfavorable course or outcome of pregnancy. Developing sensitive and specific biomarkers for IAI, preferably non-invasive biomarkers with high predictive value in the early stages when antibiotic therapy is most effective, would be a significant advancement in the prevention of preterm birth and other pregnancy complications associated with IAI.

Authors' contributions: Shipitsyna E.V. – concept and design, literature search and analysis, writing the text, approval of the final version of the article; Pachulia O.V., Bespalova O.N., Kogan I.Yu. – concept and design, literature search and analysis, text editing, approval of the final version of the article.

Conflicts of interest: The authors have no conflicts of interest to declare.

Funding: There was no funding for this study.

For citation: Shipitsyna E.V., Pachulia O.V., Bespalova O.N., Kogan I.Yu. The role of ureaplasmas in the development of preterm birth: renewed discussion in light of new data. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (10): 28-38 (in Russian) https://dx.doi.org/10.18565/aig.2023.141

ureaplasma

intra-amniotic infection

preterm birth

antibacterial therapy

Full text (in Russian)

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Received 02.06.2023

Accepted 04.10.2023

Elena V. Shipitsyna, Dr. Bio. Sci., Leading Researcher of the Department of Medical Mirobiology, D.O. Ott Reasearch Institute of Obstetrics, Gynecology and Reproductology, shipitsyna@inbox.ru, https://orcid.org/0000-0002-2309-3604, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3.
Olga V. Pachulia, PhD, Researcher, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, for.olga.kosyakova@gmail.com,
https://orcid.org/0000-0003-4116-0222, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3.
Olesya N. Bespalova, Dr. Med. Sci., Deputy Director, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology, shiggerra@mail.ru,
https://orcid.org/0000-0002-6542-5953, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3.
Igor Yu. Kogan, Corresponding Member of RAS, Dr. Med. Sci., Professor, Director, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproductology,
ovrt@ott.ru, https://orcid.org/0000-0002-7351-6900, 199034, Russia, St. Petersburg, Mendeleyevskaya Line, 3.
Corresponding author: Elena V. Shipitsyna, shipitsyna@inbox.ru

The role of ureaplasmas in the development of preterm birth: renewed discussion in light of new data

Shipitsyna E.V., Pachulia O.V., Bespalova O.N., Kogan I.Yu.

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