早產(chǎn)嬰兒常常受到各種的胎兒或新生兒疾病的致命威脅。2008年1月的愛(ài)思唯爾期刊《美國(guó)產(chǎn)科學(xué)與婦科醫(yī)學(xué)雜志》（American Journal of Obstetrics & Gynecology）上的一篇文章報(bào)道,，阿拉巴馬大學(xué)伯明翰醫(yī)學(xué)院和德雷塞爾大學(xué)醫(yī)學(xué)院的科學(xué)家發(fā)現(xiàn),，生殖道支原體是引起胎兒先天細(xì)菌感染的常見(jiàn)原因。懷孕23至32周后出生的早產(chǎn)兒中,，23%從臍帶血中檢測(cè)出感染了兩種生殖道支原體：解脲支原體和人型支原體,。
盡管80%的孕婦的陰道和子宮分泌物中都存在解脲支原體和人型支原體,，但并不是這些孕婦所生產(chǎn)的嬰兒都會(huì)感染。研究中發(fā)現(xiàn)四分之一的早產(chǎn)嬰兒出生時(shí)就已經(jīng)感染了支原體,。相比那些未受感染的新生兒,，這些受感染的新生嬰兒患嬰兒全身性炎癥反應(yīng)綜合癥、支氣管肺發(fā)育不良的幾率更高,，白細(xì)胞介素-6血清濃度更高,，胎盤炎癥發(fā)病率也更高。早產(chǎn)嬰兒中,，對(duì)應(yīng)妊娠期越短,，支原體感染檢測(cè)呈陽(yáng)性的機(jī)率越高。
該研究調(diào)查了“阿拉巴馬州早產(chǎn)研究”項(xiàng)目中1996年至2001年的連續(xù)性457例早產(chǎn)單胎案例,，共發(fā)現(xiàn)351例臍帶血支原體（解脲支原體和人型支原體）檢測(cè)呈陽(yáng)性的母嬰案例,。
德雷塞爾大學(xué)醫(yī)學(xué)院婦產(chǎn)科學(xué)系教授、醫(yī)學(xué)博士Robert Goldenberg在文章中寫道：“考慮到嬰兒先天支原體感染的幾率以及可能導(dǎo)致全身性炎癥反應(yīng)綜合癥和支氣管肺發(fā)育不良,，理所應(yīng)當(dāng)對(duì)新生嬰兒進(jìn)行支原體感染檢測(cè),，并對(duì)檢測(cè)呈陽(yáng)性的嬰兒進(jìn)行相應(yīng)的抗生素治療。由此我們自然提出一個(gè)新的問(wèn)題：對(duì)可能發(fā)生早產(chǎn)的孕婦進(jìn)行針對(duì)這兩種支原體的抗生素治療是否會(huì)降低嬰兒病發(fā)率和死亡率呢,？”
在另一篇相關(guān)社論中，美國(guó)國(guó)家兒童衛(wèi)生與人類發(fā)展研究所（NICHD/NIH）圍產(chǎn)期學(xué)研究分支主任和項(xiàng)目主管,，韋恩州立大學(xué)分子產(chǎn)科學(xué)和遺傳學(xué)教授,，醫(yī)學(xué)博士Roberto Romero和加利福尼亞大學(xué)婦產(chǎn)科學(xué)系名譽(yù)教授，醫(yī)學(xué)博士Thomas J. Garite發(fā)表評(píng)論說(shuō)：“這篇文章明白地表明嬰兒先天細(xì)菌感染比我們從前以為的多?，F(xiàn)在生殖道支原體檢測(cè)還不是常規(guī)臨床婦產(chǎn)檢查的內(nèi)容,。對(duì)疑似膿血癥嬰兒的常規(guī)治療自然也就不包括針對(duì)支原體的抗生素治療。”
Romero 和 Garite進(jìn)一步指出：“最初大家只是懷疑生殖道支原體是否會(huì)引起胎兒/新生兒疾病,。但隨著生殖道支原體導(dǎo)致新生兒膿血癥,、肺炎、腦膜炎和腦部病變的病例不斷出現(xiàn),，可以確認(rèn)這就是罪魁禍?zhǔn)?。新生兒呼吸系統(tǒng)感染支原體還有可能誘發(fā)慢性肺部疾病。” （科學(xué)網(wǎng) 荔濤/編譯）
生物谷推薦原始出處：
American Journal of Obstetrics and Gynecology
Volume 198, Issue 1, January 2008, Pages 43.e1-43.e5
The Alabama Preterm Birth Study: Umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis cultures in very preterm newborn infants
Robert L. Goldenberg MDa, William W. Andrews PhD, MDb, Alice R. Goepfert MDb, Ona Faye-Petersen MDc, Suzanne P. Cliver BSb, Waldemar A. Carlo MDd and John C. Hauth MDb
aDepartment of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, PA
bDepartment of Obstetrics and Gynecology, University of Alabama–Birmingham Medical School, Birmingham, AL
cDepartment of Pathology, University of Alabama–Birmingham Medical School, Birmingham, AL
dDepartment of Pediatrics, University of Alabama–Birmingham Medical School, Birmingham, AL.
Received 14 March 2007; revised 30 May 2007; accepted 23 July 2007. Available online 31 December 2007.
Objective
This study was undertaken to evaluate the frequency of umbilical cord blood infections with Ureaplasma urealyticum and Mycoplasma hominis in preterm 23- to 32-week births and to determine their association with various obstetric conditions, markers of placental inflammation, and newborn outcomes.
Study Design
351 mother/infant dyads with deliveries between 23 and 32 weeks’ gestational age who had cord blood cultures for U urealyticum and M hominis had their medical records abstracted, other placental cultures performed, cord interleukin-6 levels determined, placentas evaluated histologically, and infant outcomes determined.
Results
U urealyticum and/or M hominis were present in 23% of cord blood cultures. Positive cultures were more common in infants of nonwhite women (27.9% vs 16.8%; P = .016), in women less than 20 years of age, in those undergoing a spontaneous compared to an indicated preterm delivery (34.7% vs 3.2%; P = .0001), and in those delivering at earlier gestational ages. Intrauterine infection and inflammation were more common among infants with a positive U urealyticum and M hominis culture as evidenced by placental cultures for these and other bacteria, elevated cord blood interleukin-6 levels, and placental histology. Infants with positive cord blood U urealyticum and M hominis cultures were more likely to have neonatal systemic inflammatory response syndrome (41.3% vs 25.7%; P = .007; adjusted odds ratio, 1.86; 1.08-3.21) and probably bronchopulmonary dysplasia (26.8% vs 10.1%; P = .0001; adjusted odds ratio 1.99; 0.91-4.37), but were not significantly different for other neonatal outcomes, including respiratory distress syndrome, intraventricular hemorrhage, or death.
Conclusion
U urealyticum and M hominis cord blood infections are far more common in spontaneous vs indicated preterm deliveries and are strongly associated with markers of acute placental inflammation. Positive cultures are associated with neonatal systemic inflammatory response syndrome and probably bronchopulmonary dysplasia.
Key words: bronchopulmonary dysplasia; Mycoplasma hominis; neonatal outcome; neonatal systemic inflammatory response syndrome; placental histology; preterm birth; umbilical cord blood; Ureaplasma urealyticum
Cite this article as: Goldenberg RL, Andrews WW, Goepfert AR, et al. The Alabama Preterm Birth Study: Umbilical cord blood Ureaplasma urealyticum and Mycoplasma hominis cultures in very preterm newborn infants. Am J Obstet Gynecol 2008;198:43.e1-43.e5.Reprints not available from the authors.Funded by the NICHD PERC grant (HD 33927).
