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

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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.

Sobre autores

Elena Shipitsyna

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Autor responsável pela correspondência
Email: shipitsyna@inbox.ru
ORCID ID: 0000-0002-2309-3604

Dr. Bio. Sci., Leading Researcher of the Department of Medical Mirobiology

Rússia, St. Petersburg

Olga Pachulia

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Email: for.olga.kosyakova@gmail.com
ORCID ID: 0000-0003-4116-0222

PhD, Researcher

Rússia, St. Petersburg

Olesya Bespalova

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Email: shiggerra@mail.ru
ORCID ID: 0000-0002-6542-5953

Dr. Med. Sci., Deputy Director

Rússia, St. Petersburg

Igor Kogan

D.O. Ott Research Institute for Obstetrics, Gynecology and Reproductology

Email: ovrt@ott.ru
ORCID ID: 0000-0002-7351-6900

Corresponding Member of RAS, Dr. Med. Sci., Professor, Director

Rússia, St. Petersburg

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