Pathogens identified in the internal tissues and placentas of stillbirths: Results from the prospective, observational PURPOSe study

Document Type

Article

Department

Obstetrics and Gynaecology; Pathology and Laboratory Medicine

Abstract

Objective: To examine internal organ tissues and placentas of stillbirths for various pathogens.
Design: Prospective, observational study.
Settings: Three study hospitals in India and a large maternity hospital in Pakistan.
Population: Stillborn infants delivered in a study hospital.
Methods: A prospective observational study.
Main outcome measures: Organisms identified by pathogen polymerase chain reaction (PCR) in internal organs and placental tissues of stillbirths.
Results: Of 2437 stillbirth internal tissues, 8.3% (95% CI 7.2-9.4) were positive. Organisms were most commonly detected in brain (12.3%), cerebrospinal fluid (CSF) (9.5%) and whole blood (8.4%). Ureaplasma urealyticum/parvum was the organism most frequently detected in at least one internal organ (6.4% of stillbirths and 2% of all tissues). Escherichia coli/Shigella was the next most common (4.1% one or more internal organ tissue sample and 1.3% of tissue samples), followed by Staphylococcus aureus in at least one internal organ tissue (1.9% and 0.9% of all tissues). None of the other organisms was found in more than 1.4% of the tissue samples in stillbirths or more than 0.6% of the internal tissues examined. In the placenta tissue, membrane or cord blood combined, 42.8% (95% CI 40.2-45.3) had at least one organism identified, with U. urealyticum/parvum representing the most commonly identified (27.8%).
Conclusions: In about 8% of stillbirths, there was evidence of a pathogen in an internal organ. Ureaplasma urealyticum/parvum was the most common organism found in the placenta and in the internal tissues, especially in the fetal brain.

Comments

Volume, issue, and pagination are not provided by the author/publisher.

Publication (Name of Journal)

BJOG: An International Journal of Obstetrics & Gynaecology

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