Downloaded from www.microbiologyresearch.org by IP: 54.70.40.11 On: Thu, 25 Oct 2018 22:51:40 J. Med. Microbiol. - Vol. 24 (1987), 253-257 0 1987 The Pathological Society of Great Britain and Ireland The role of mycoplasmas, ureaplasmas and chlamydiae in the genital tract of women presenting in spontaneous early preterm labour R. F. LAMONT", D. TAYLOR-ROBINSONt, J. S. WIGGLESWORTHS, P. M. FURRt, R. T. EVANSt and M. G. ELDER Institute of Obstetrics and G ynaecolog y and *Department of Paediatric and Neonatal Medicine, Hammersmith Hospital, 1 ondon and t Division of Sexually Transmitted Diseases, MRC Clinical Research Centre, Watford Road, Harrow, Middlesex Summary. The genital carriage of Ureaplasma urealyticum, Mycoplasma hominis and Chlamydia trachomatis was assessed in 72 women admitted to hospital in spontaneous preterm labour and in 26 women requiring preterm delivery for other reasons who formed a control group. Women in preterm labour significantly more often carried ureaplasmas, had large numbers of M . hominis and subsequently developed chorioamnionitis than women in the control group. M. hominis, in particular, occurred more frequently and in large numbers in women who had chorioamnionitis associated with ruptured membranes. Genital carriage of the various micro-organisms appeared not to be associated with fetal growth retardation, although subsequent isolation of ureaplasmas from infants was common. It is suggested that mid-second-trimester vaginal specimens should be cultured on a research basis to establish whether these various micro-organisms identify women at risk of labouring preterm. Introduction The aetiology of preterm labour is multifactorial (Turnbull and Anderson, 1978) and infection is thought to be one of the precipitating factors (Minkoff, 1983). Genital mycoplasmas have been associated with nonspecific vaginitis (bacterial vaginosis) and are considered to be one of the causes of pelvic inflammatory disease (PID) and post-abortal and post-partum fever (Taylor-Robin- son and McCormack, 1980a). Furthermore, there is increasing interest in the role of genital myco- plasmas in disorders of reproduction, namely infertility, habitual abortion and stillbirth, low birth weight and prematurity (Taylor-Robinson and McCormack, 1980b). Genital immunotypes of Chlamydia trachomatis are a cause of cervicitis and PID, with its associated infertility, and are candi- dates for causal roles in the aforementioned reproductive problems (Taylor-Robinson and Thomas, 1980). To assess the importance of Ureaplasma urealyticum, My coplasma hominis and chlamydiae in perinatal disease, we have conducted Received 14 Nov. 1986; accepted 31 Dec. 1986. * Present address to which requests for offprints should be sent : Department of Human Reproduction and Obstetrics, Princess Anne Hospital, Coxford Road, Southampton SO9 4HA. a prospective study of the occurrence of these micro-organismsin the lower genital tract of women presenting in spontaneous early preterm labour compared to their occurrence in a group of pregnant women not in labour but at the same gestational stage. Subjects studied and methods Subjects Ninety-eight women were investigated and informed consent was obtained from all of them. They consisted of a study group of 72 patients and a control group of 26 patients. The study group comprised women who pre- sented in labour between 26 weeks and 33 completed weeks of pregnancy. The control group comprised women who were not in labour but who required abdominal delivery before 34 weeks of gestation because of some fetal or maternal complication of pregnancy. There were no differences between the study and control groups with respect to age, race, social class, or mean gestational age (table I), but more of the patients in the control group were primigravidae and had smaller babies, and whereas only 28 (39%) of the patients in the study group had intact membranes at the time of investigation, all those in the control group had intact membranes. Neonatal infection was diagnosed if there was a 253