American Journal of Epidemiology Vol. 129, No. 6: 1247-1257
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health
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ASSOCIATION OF CHLAMYDIA TRACHOMATIS AND MYCOPLASMA HOMINIS WITH INTRAUTERINE GROWTH RETARDATION AND PRETERM DELIVERY
INVESTIGATORS OF THE JOHNS HOPKINS STUDY OF CERVICITIS AND ADVERSE PREGNANCY OUTCOME1
The authors conducted a prospective study of risk factors for intrauterine growth retardation (birth weight less than a standard (race- and sex-adjusted) 10th percentile for gestational age) and preterm birth (birth prior to 37 weeks gestation) in a high-risk, inner-city, obstetric population, with special interest in pathogens colonizing the maternal genital tract. A total of 801 women within 22 to 30 weeks of gestation were enrolled and interviewed. Subjects were cultured for Gardnerella vaginalls, group B streptococcus, Trichomonas vaginalis, Neisseria gonorrhoeae, Bacteroides fragills, Mycoplasma hominis, Ureaplasma urealyticum, Chiamydia trachomatis, and Candida albicans, and they were followed to delivery. Intrauterine growth retardation and preterm delivery occurred in 8% and 13% of these pregnancies, respectively. After adjustment for other important risk factors, colonization with C. trachomatis was significantly associated both with intrauterine growth retardation (odds ratio = 2.4, 90% confidence interval 1.32–4.18) and preterm delivery (odds ratio = 1.6, 90% confidence interval 1.0 1–2.50). Colonization with C. albicans was significantly associated with intrauterine growth retardation (odds ratio = 1.9, 90% confidence interval 1.20–3.14); colonization with M. hominis was significantly associated with preterm birth (odds ratio = 2.0, 90% confidence interval 1.42–2.93). These associations support the probable role of infection in preterm and intrauterine growth retardation births and suggest the need for carefully designed intervention studies.
Candlda albicans; Chiamydia trachomatis; delivery; fetal growth retardation; low birth weight; Mycoplasma infections
Reprint requests to Dr. Alvaro Muņoz, Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health, 615 N. Wolfe Street, Baltimore, MD 21205
1The Investigators of The Johns Hopkins Study of Cervicitis and Adverse Pregnancy Outcome are from The Johns Hopkins School of Hygiene and Public Health, Baltimore, MD: Dr. B. Frank Polk,* Dr. Linda Berlin, Dr. Sukon Kanchanaraksa, Dr. Alvaro Muņoz, Florence Kramer; The Johns Hopkins Hospital: Dr. Michael Spence, Dr. Thomas Quinn, Dr. Gary Hoffman, Dr. Kevin Winn, Dr. John Repke, Dr. M. Douglas Jones, Jr., Dr. John Bartlett, Dr. Barbara Laughon, Linda Bobo, Dr. Janet Horn, Beth Kappus, Dr. C. F. T. Mattern, Mary Brockman, Pam Donohue, Valerie Lievers, Jean Wheeler, National Institute of Child Health and Human Development Dr. Robert Nugent, Dr. George Rhoads.
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