The role of infection in preterm labour and delivery

作者：Roberto J. Romero, Ricardo Gómez, Tinnakorn Chaiworapongsa, G. Conoscenti, Ju Cheol Kim, Yeon Mee Kim · 发表于：Paediatric and Perinatal Epidemiology · 年份：2001 · DOI：10.1046/j.1365-3016.2001.00007.x · 被引用次数：401 · 研究领域：Preterm Birth and Chorioamnionitis、Infant Nutrition and Health、Reproductive Physiology in Livestock

A strong body of evidence suggests that infection plays a role in the pathogenesis of preterm labour and delivery. Moreover, recent evidence indicates that intrauterine infection may also be involved in the genesis of significant neonatal and infant complications such as periventricular leukomalacia, bronchopulmonary dysplasia and cerebral palsy. This article reviews the evidence linking infection with pre-term delivery. Three lines of evidence support a role for infection in the onset of preterm labour: • administration of bacteria or bacterial products to animals results in either abortion or labour; • systemic maternal infections such as pyelonephritis, pneumonia, malaria, and typhoid fever are associated with the onset of labour; • intrauterine infection is associated with preterm labour and delivery. Infection-induced preterm labour and delivery in animals. Considerable evidence derived from animal experimentation indicates that administration of micro-organisms or microbial products (e.g. endotoxin) to pregnant animals can induce preterm labour and delivery.1–4 In 1943, Zahl and Bjerknes5 demonstrated that injection of Shigella and Salmonella endotoxin into mice and rabbits was capable of inducing abortion. Takeda and Tsuchiya6 confirmed this observation by administering Escherichia coli endotoxin to pregnant mice and rabbits. Furthermore, immunisation of animals with an anti-endotoxin antibody ameliorates the biological effect of endotoxin.7 Animal models of ascending ...