Michal Koucký1, Karin Malíčková2, Tereza Cindrová-Davies3, Jan Smíšek4, Hana Vráblíková4, Andrej Černý4, Patrik Šimják4, Miroslava Slováčková2, Antonín Pařízek4, Tomáš Zima2. 1. Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic. Electronic address: michalkoucky@seznam.cz. 2. Institute of Medical Biochemistry and Laboratory Diagnostics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic. 3. Department of Physiology, Development and Neuroscience, University of Cambridge, United Kingdom. 4. Department of Gynecology and Obstetrics of the First Faculty of Medicine and General Teaching Hospital, Charles University in Prague, Czech Republic.
Abstract
BACKGROUND: Preterm birth is a leading cause of perinatal mortality and morbidity. Heavy cervicovaginal Ureaplasma colonization is thought to play a role in the pathogenesis of preterm birth. The administration of vaginal progesterone has been shown to reduce the incidence of preterm birth in women with short cervical length. Steroid hormones seem to modulate the presence of microorganisms in the vagina. The aim of this study was to assess whether the treatment with vaginal progesterone could reduce the incidence of preterm birth and cervicovaginal colonization by Ureaplasma urealyticum in a cohort of pregnant women with threatened preterm labor. METHODS: A cohort of 63 females who presented with regular contractions and/or short cervical length between 24-32 weeks of gestation were recruited into a prospective study. 70% of patients had been treated with vaginal progesterone prior to recruitment and these patients continued with the treatment until birth. All patients were tested for the presence of cervicovaginal Ureaplasma urealyticum colonization at admission. The primary endpoint was preterm birth before 37 weeks. RESULTS: The incidence of preterm delivery was significantly increased in patients who tested positive for Ureaplasma urealyticum. Prolonged vaginal progesterone administration was associated with less frequent cervicovaginal colonization by U. urealyticum. Cervicovaginal colonization by U. urealyticum and absence of progesterone treatment were identified as two independent risk factors for preterm delivery. CONCLUSIONS: Our results demonstrate the beneficial effects of progesterone administration in reducing the incidence of cervicovaginal colonization by Ureaplasma urealyticum.
BACKGROUND: Preterm birth is a leading cause of perinatal mortality and morbidity. Heavy cervicovaginal Ureaplasma colonization is thought to play a role in the pathogenesis of preterm birth. The administration of vaginal progesterone has been shown to reduce the incidence of preterm birth in women with short cervical length. Steroid hormones seem to modulate the presence of microorganisms in the vagina. The aim of this study was to assess whether the treatment with vaginal progesterone could reduce the incidence of preterm birth and cervicovaginal colonization by Ureaplasma urealyticum in a cohort of pregnant women with threatened preterm labor. METHODS: A cohort of 63 females who presented with regular contractions and/or short cervical length between 24-32 weeks of gestation were recruited into a prospective study. 70% of patients had been treated with vaginal progesterone prior to recruitment and these patients continued with the treatment until birth. All patients were tested for the presence of cervicovaginal Ureaplasma urealyticum colonization at admission. The primary endpoint was preterm birth before 37 weeks. RESULTS: The incidence of preterm delivery was significantly increased in patients who tested positive for Ureaplasma urealyticum. Prolonged vaginal progesterone administration was associated with less frequent cervicovaginal colonization by U. urealyticum. Cervicovaginal colonization by U. urealyticum and absence of progesterone treatment were identified as two independent risk factors for preterm delivery. CONCLUSIONS: Our results demonstrate the beneficial effects of progesterone administration in reducing the incidence of cervicovaginal colonization by Ureaplasma urealyticum.
Authors: Nathalia M Noda-Nicolau; Ourlad Alzeus G Tantengco; Jossimara Polettini; Mariana C Silva; Giovana F C Bento; Geovanna C Cursino; Camila Marconi; Ronald F Lamont; Brandie D Taylor; Márcia G Silva; Daniel Jupiter; Ramkumar Menon Journal: Front Microbiol Date: 2022-03-30 Impact factor: 5.640
Authors: Marinjho Emely Jonduo; Lisa Michelle Vallely; Handan Wand; Emma Louise Sweeney; Dianne Egli-Gany; John Kaldor; Andrew John Vallely; Nicola Low Journal: BMJ Open Date: 2022-08-26 Impact factor: 3.006