Abstract 1577 Poster Session II, Sunday, 5/2 (poster 128)

BACKGROUND: Intrauterine infection is often evident in cases of preterm birth and may be preceded by bacterial vaginosis. Although many different organisms have been implicated in the pathogenesis of these infections, UU is often isolated in cases of bacterial vaginosis or from the placenta or fetal membrane after preterm delivery. Identification of IgM against UU in mother or baby may help distinguish infection from colonization. OBJECTIVE: To determine the level of IgM against UU that can be detected at birth in the serum of babies born very preterm compared to those born at term. METHODS: Serum samples were obtained on the first day of life from a group of preterm neonates enrolled in a randomized trial of α1-Proteinase Inhibitor for the prevention of chronic lung disease. Cord blood from a group of healthy full-term neonates was also obtained. Samples were analyzed by immunoperoxide assay for the presence of serovar-specific IgM against UU. RESULTS: Serum was obtained from 55 babies with birth weights of 600-1250g and 32 healthy full-term controls. While the serum from many babies in both groups contained IgM against UU at low titre, high titres were specific to the preterm group. Titres of ≥ 1:800 were the most reproducible and the receiver operating characteristics (ROC) curve evaluating the ability of different titres to distinguish preterm from term birth revealed that titres of 1:800 or 1:1600 performed best. (Table) CONCLUSIONS: The majority of preterm neonates with birth weights of less than 1250g in this study had high titres of IgM to UU in their serum at birth whereas those born at full term did not. Intrauterine infection with UU may be an important factor in the pathogenesis of preterm delivery and antimicrobial therapy directed against UU may be effective in preventing a significant proportion of preterm births.

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(Funded by the Bayer/CRCS Research and Development Fund)