Effect of <i>Mycoplasma hominis</i> and cytomegalovirus infection on pregnancy outcome: A prospective study of 200 Mongolian women and their newborns

<div><p>In Mongolia, diagnostic tests for the detection of the sexually transmitted mycoplasmas, ureaplasmas, Herpes simplex virus (HSV), and cytomegalovirus (CMV) are currently not routinely used in clinical settings and the frequency of these STIs are enigmatic. The prevalence of these STI pathogens were prospectively evaluated among 200 Mongolian pregnant women and their newborns and correlated with pregnancy outcome. TaqMan PCRs were used to detect bacterial and viral STI pathogens in pre-birth vaginal swabs of the pregnant women and in oral swabs of their newborns. A standardized questionnaire concerning former and present pregnancies was developed and linear regression analysis was used to correlate pathogen detection with pregnancy outcome. Ureaplasmas were the most prevalent of the tested pathogens (positive in 90.5% positive women and 47.5% newborns), followed by mycoplasmas (32.5% and 7.5%), chlamydia (14.5% and 7.5%), trichomonas (8.5% and 4.0%) and gonococcus (0.5% and 0%). CMV was found in 46.5% of the pregnant women and in 10.5% of their newborns, whereas HSV-2 was detected in only two mothers. Multiple regression analyses indicate that colonization of the mothers with <i>U</i>. <i>urealyticum</i>, <i>M</i>. <i>hominis</i>, <i>T</i>. <i>vaginalis</i> or CMV is associated with transmission to newborns and that transmission of <i>M</i>. <i>hominis</i> or CMV from Mongolian pregnant women to offspring is associated with reduced neonatal length and gestational age. Thus, diagnostic tests for their detection should be implemented in the clinical settings in Mongolia.</p></div

Characteristics of 200 pregnant women from Mongolia, Ulaanbaatar.

<p>Characteristics of 200 pregnant women from Mongolia, Ulaanbaatar.</p

STI-pathogen load in mothers and their newborns.

<p>Quantities of each pathogen were normalized to human cells (pathogen-GE /10⁶ GAPDH-GE) and the mean (+/- standard deviation) of the 200 values of mothers (_M) and newborns (_N) depicted as (x+1) to visualize even the negative detections in column scatter plot.</p

Correlation of pathogen load and pregnancy outcome.

<p>Correlation of pathogen load and pregnancy outcome.</p

Quantities of <i>M</i>. <i>hominis</i>, CMV and <i>U</i>. <i>parvum</i> with respect to gestational age.

<p>Column scatter plots indicate the mean genome equivalents of <i>M</i>. <i>hominis</i>, CMV and <i>U</i>. <i>parvum</i> in maternal and neonatal specimens, normalized to 10⁶ GAPDH genome equivalents, in 2 GA -weeks intervals from 35–36 to 39–40. Statistically significant differences were assessed by Kruskal-Wallis test between GA-groups 35–36 and 38–39 or 39–40, respectively (p-values < 0,05).</p

Co-localizing STI pathogens.

<p>Stacked bar charts indicate the decreasing number of specimens (with respect to the maternal colonization; from left) with detected pathogens and pathogen-communities in the 200 maternal vaginal specimens (Mothers) and 200 neonatal oral specimens (Newborns). Abbreviations indicate the respective microorganisms: Up, <i>U</i>. <i>parvum</i>, Uu, <i>U</i>. <i>urealyticum</i>; Mh, <i>M</i>. <i>hominis</i>; Mg, <i>M</i>. <i>genitalium</i>; Ct, <i>C</i>. <i>trachomatis</i>, Tv, <i>T</i>.<i>vaginalis</i>; and CM, CMV.</p