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

Aim

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.

Methods

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.

Results

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).

Conclusion

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.