TY - JOUR
T1 - Pathogens identified in the internal tissues and placentas of stillbirths
T2 - results from the prospective, observational PURPOSe study
AU - Harakuni, Sheetal U.
AU - Somannavar, Manjunath S.
AU - Ghanchi, Najia K.
AU - Ahmed, Imran
AU - Zafar, Afia
AU - Kim, Jean
AU - Tikmani, Shiyam Sunder
AU - Hwang, Kay
AU - Saleem, Sarah
AU - Goudar, Shivaprasad S.
AU - Dhaded, Sangappa
AU - Guruprasad, Gowder
AU - Yasmin, Haleema
AU - Yogeshkumar, S.
AU - Aceituno, Anna
AU - Silver, Robert M.
AU - McClure, Elizabeth M.
AU - Goldenberg, R. L.
AU - Nagmoti, Mahantesh B.
AU - Aradhya, Gayathri H.
AU - Nadig, Naveen
AU - Kusgur, Varun
AU - Raghoji, Chaitali R.
AU - Siddartha, E. S.
AU - Patil, Lingaraja Gowda C.
AU - Pujar, Sneharoopa
AU - Dhananjaya, Shobha
AU - Sarvamangala, B.
AU - Prakash, Veena
AU - Mangala, G. K.
AU - Rajashekhar, K. S.
AU - Sunilkumar, K. Byranahalli
AU - Kulkarni, Vardendra
AU - Nagaraj, T. S.
AU - Jeevika, M. U.
AU - Joish, Upendra Kumar
AU - Harikiran, Reddy R.
AU - Uddin, Zeeshan
AU - Ariff, Shabina
AU - Roujani, Sana
AU - Reza, Sayyeda
AU - Yasmin, Haleema
AU - Bano, Khadija
AU - Raza, Jamal
AU - Parkash, Jai
AU - Parlberg, Lindsay
AU - Moore, Janet L.
AU - Parepelli, Suchita
AU - Bann, Carla
N1 - Publisher Copyright:
© 2023 John Wiley & Sons Ltd.
PY - 2023/9
Y1 - 2023/9
N2 - 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.
AB - 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.
KW - India
KW - PCR
KW - Pakistan
KW - infection
KW - minimall invasive tissue sampling
KW - placenta
KW - stillbirth
UR - http://www.scopus.com/inward/record.url?scp=85153173723&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.17479
DO - 10.1111/1471-0528.17479
M3 - Article
C2 - 37069731
AN - SCOPUS:85153173723
SN - 1470-0328
VL - 130
SP - 1238
EP - 1246
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
IS - 10
ER -