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

Sheetal U. Harakuni, Manjunath S. Somannavar, Najia K. Ghanchi, Imran Ahmed, Afia Zafar, Jean Kim, Shiyam Sunder Tikmani, Kay Hwang, Sarah Saleem, Shivaprasad S. Goudar, Sangappa Dhaded, Gowder Guruprasad, Haleema Yasmin, S. Yogeshkumar, Anna Aceituno, Robert M. Silver, Elizabeth M. McClure, R. L. Goldenberg, Mahantesh B. Nagmoti, Gayathri H. AradhyaNaveen Nadig, Varun Kusgur, Chaitali R. Raghoji, E. S. Siddartha, Lingaraja Gowda C. Patil, Sneharoopa Pujar, Shobha Dhananjaya, B. Sarvamangala, Veena Prakash, G. K. Mangala, K. S. Rajashekhar, K. Byranahalli Sunilkumar, Vardendra Kulkarni, T. S. Nagaraj, M. U. Jeevika, Upendra Kumar Joish, Reddy R. Harikiran, Zeeshan Uddin, Shabina Ariff, Sana Roujani, Sayyeda Reza, Haleema Yasmin, Khadija Bano, Jamal Raza, Jai Parkash, Lindsay Parlberg, Janet L. Moore, Suchita Parepelli, Carla Bann

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

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.

Original languageEnglish
Pages (from-to)1238-1246
Number of pages9
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume130
Issue number10
DOIs
Publication statusPublished - Sept 2023

Keywords

  • India
  • PCR
  • Pakistan
  • infection
  • minimall invasive tissue sampling
  • placenta
  • stillbirth

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