Correlation analysis of the prenatal treatment of Azithromycin for maternal ureaplasma urealyticum colonization and the very low birth weight infants' disease

LI Jiang; WANG Tuanmei; LUO Hui

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Journal of Hunan Normal University(Medical Science) ›› 2025, Vol. 22 ›› Issue (1) : 73-77.

Correlation analysis of the prenatal treatment of Azithromycin for maternal ureaplasma urealyticum colonization and the very low birth weight infants' disease

LI Jiang^1,2, WANG Tuanmei^1,2, LUO Hui²

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Abstract

Objective To investigate the correlation between the prenatal treatment of Azithromycin for maternal ureaplasma urealyticum (UU) colonization and the rate of the very low birth weight infants' (VLBWIs) complications. Methods This was a retrospective single center analysis which involves the gravidas who underwent prenatal examination and delivery in Changsha Hospital for Maternal & Child Healthcare, and their VLBWIs who was hospitalized in the NICU (Neonatal Intensive Care Unit) from January 2018 to May 2023 were employed as the study subjects. According to the results of UU-DNA of maternal cervical secretion, all the VLBWIs were divided into three groups: Group A: UU-DNA was positive (+), and the VLBWIs' mothers were received the prenatal treatment of Azithromycin (AZ); Group B: UU-DNA was positive (+), while the VLBWIs' mothers didn't receive AZ treatment; Group C: UU-PCR was negative. The general data of VLBWIs and their mothers' perinatal data, the situation of the respiratory systems and the complications of the VLBWIs were compared between the three groups. Results 253 VLBWIs were included in this study (group A: 132, group B: 39, group C: 82). The UU infection rate of group C was significantly lower than other two groups, whereas the ratio of IVF-ET was significantly higher than other two groups. Among them, compared with group C, the incidence of NEC in group B was significantly higher, whereas the incidence of NEC in group A was lower than that in group B. The incidence of hsPDA in group B was significantly decreased, and the rate of positive pressure ventilation <7d in group A was significantly increased, with statistical significance. Compared to group B, the incidence of NRDS in group A was significantly decreased, and the difference was statistically significant. Conclusion AZ treatment of maternal UU colonization during pregnancy may reduce the incidence of NEC and NRDS in VLBWIs and shorten the positive pressure ventilation time of VLBWIs.

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ureaplasma urealyticum / azithromycin / very low birth weight infants

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LI Jiang, WANG Tuanmei, LUO Hui. Correlation analysis of the prenatal treatment of Azithromycin for maternal ureaplasma urealyticum colonization and the very low birth weight infants' disease[J]. Journal of Hunan Normal University(Medical Science). 2025, 22(1): 73-77

References

[1] VENTURELLI N, ZEIS A, DE BERITTO T, et al.Ureasplasma and Its Role in Adverse Perinatal Outcomes: A Review[J]. Neoreviews, 2021, 22(9): e574-e584.
[2] MA J, WANG Z, LUO C, et al.Epidemiological and Clinical Characteristics of Neonatal Ureaplasma urealyticum Infection[J]. Infect Drug Resist, 2024, 17: 1323-1332.
[3] RITTENSCHOBER-BOEHM J, FUIKO R, FARR A, et al.Intrauterine Detection of Ureaplasma Species after Vaginal Colonization in Pregnancy and Neonatal outcome[J]. Neonatology, 2024, 121(2): 187-194.
[4] OH KJ, ROMERO R, PARK JY, et al.The earlier the gestational age, the greater the intensity of the intra-amniotic inflammatory response in women with preterm premature rupture of membranes and amniotic fluid infection by Ureaplasma species[J]. J Perinat Med, 2019, 47(5): 516-527.
[5] MARCIN PRZYBYLSKI, ILONA WICHER-GOZDUR, JOANNA KIPPEN, et al.Effect of Ureaplasma/Mycoplasma genital tract infection on preterm labor[J]. Ginekol Pol, 2024, 95(12): 959-965.
[6] INATOMI T, OUE S, OGIHARA T, et al.Antenatal exposure to ureaplasma species exacerbates bronchopulmonary dysplasia synergistically with subsequent prolonged mechanical ventilation in preterm infants[J]. Pediatr Res, 2012, 71( 3): 267–273.
[7] DASKALAKIS G, PSARRIS A, KOUTRAS A, et al.Maternal Infection and Preterm Birth: From Molecular Basis to Clinical Implications[J]. Children (Basel), 2023, 10(5): 907.
[8] OZDEMIR R, SARI FN, TUNAY ZO, et al.The association between respiratory tract Ureaplasma urealyticum colonization and severe retinopathy of prematurity in preterm infants ≤1250 g[J]. Eye (Lond), 2012, 26(7): 992-996.
[9] SPRONG KE, MABENGE M, WRIGHT CA, et al.Ureaplasma species and preterm birth: current perspectives[J]. Crit Rev Microbiol, 2020, 46(2): 169-181.
[10] JEPP CK, FOLEY DA, CHUA IJ, et al.Ureaplasma urealyticum meningitis complicated by hydrocephalus in a preterm neonate[J]. J Paediatr Child Health, 2022, 58(3): 529-531.
[11] GOBEC K, MUKENAUER R, KEŠE D, et al. Association between colonization of the respiratory tract with Ureaplasma species and bronchopulmonary dysplasia in newborns with extremely low gestational age: a retrospective study[J]. Croat Med J, 2023, 64(2): 75-83.
[12] FAN W, WANG Q, LIANG Z, et al.Efficacy of azithromycin in treating Ureaplasma urealyticum: a systematic review and meta-analysis[J]. BMC Infect Dis, 2023, 23(1): 163.
[13] VISCARDI RM, TERRIN ML, MAGDER LS, et al.Randomised trial of azithromycin to eradicate Ureaplasma in preterm infants[J]. Arch Dis Child Fetal Neonatal Ed, 2020, 105(6): 615-622.
[14] PANDELIDIS K, MCCARTHY A, CHESKO KL, et al.Role of biofilm formation in Ureaplasma antibiotic susceptibility and development of bronchopulmonary dysplasia in preterm neonates[J]. Pediatr Infect Dis J, 2013, 32(4): 394-398.
[15] HIGGINS RD, JOBE AH, KOSO-THOMAS M, et al.Bronchopulmonary dysplasia: executive summary of a workshop[J]. J Pediatr, 2018, 197: 300-308.
[16] BANCALARI M A, SCHADE R. Retinopatía del prematuro: Actualización en detección y tratamiento [Retinopathy of the premature: Update in screening and treatment][J]. Rev Chil Pediatr, 2020, 91(1): 122-130. Spanish.
[17] DONG XY, LI JZ, LUO KR, et al.Interpretation of the UK screening and treatment of retinopathy of prematurity updated 2022 guidelines[J]. CJCP, 2024, 26(5): 437-443.
[18] 邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学[M]. 第5版. 北京: 人民卫生出版社, 2018: 423.
[19] 谢幸, 孔北华, 段涛. 妇产科学[M]. 第9版. 北京: 人民卫生出版社, 2020: 121.
[20] BALLARD HO, SHOOK LA, BERNARD P, et al.Use of azithromycin for the prevention of bronchopulmonary dysplasia in preterm infants: a randomized, double-blind, placebo controlled trial[J]. Pediatr Pulmonol, 2011, 46: 111-118.
[21] XUEYU CHEN, XUEMEI HUANG, YANQING LIN, et al.Association of Ureaplasma infection pattern and azithromycin treatment effect with bronchopulmonary dysplasia in Ureaplasma positive infants: a cohort study[J]. BMC Pulm Med, 2023, 23(1): 229.
[22] SPRONG KE, MABENGE M, WRIGHT CA, et al.Ureaplasma species and preterm birth: current perspectives[J]. Crit Rev Microbiol, 2020, 46(2): 169-181.
[23] 钟林平, 蒋燕, 栗燕, 等. 超早产儿/超低出生体重儿呼吸道解脲脲原体定植与支气管肺发育不良的关系[J]. 中华围产医学杂志, 2023, 26(3): 236-242.
[24] OKOGBULE-WONODIA, GROSSG, SUNCC, et al.Necrotizing enterocolitis is associated with ureaplasma colonization in preterm infants[J]. Pediatr Res, 2011, 69(5pt1): 442-447.
[25] SILWEDEL C, SPEER CP, GLASER K.Ureaplasma-associated prenatal, perinatal, and neonatal morbidities[J]. Expert Rev Clin Immunol, 2017, 13(11): 1073-1087.
[26] WOLFS TG, KALLAPUR SG, KNOX CL, et al.Antenatal ureaplasma infection impairs development of the fetal ovine gut in an IL-1 dependent manner[J]. Mucosal Immunol, 2013, 6(3): 547-556.
[27] HEYMANS C, DE LANGE IH, HÜTTEN MC, et al. Chronic Intra-Uterine Ureaplasma parvum Infection Induces Injury of the Enteric Nervous System in Ovine Fetuses[J]. Front Immunol, 2020, 11: 189.
[28] 李秋平. 围生期解脲支原体感染与不良孕产结局及新生儿疾病关联[J]. 中国儿童保健杂志, 2022, 30(10): 1049-1052, 1067.
[29] SUN T, FU J.Analysis of the Clinical Features of Intrauterine Ureaplasma urealyticum Infection in Preterm Infants: A Case-Control Study[J]. Front Pediatr, 2021, 9: 774150.
[30] 魏红玲, 邢燕, 周颖, 等. 胎龄小于32周早产儿解脲脲原体肺炎的临床特征分析[J]. 中华预防医学杂志, 2021, 55(2): 239-244.