RTI uses cookies to offer you the best experience online. By clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.
Pathogens identified in the internal tissues and placentas of stillbirths
Results from the prospective, observational PURPOSe study
Harakuni, S. U., Somannavar, M. S., Ghanchi, N. K., Ahmed, I., Zafar, A., Kim, J., Tikmani, S. S., Hwang, K., Saleem, S., Goudar, S. S., Dhaded, S., Guruprasad, G., Yasmin, H., Yogeshkumar, S., Aceituno, A., Silver, R. M., McClure, E. M., Goldenberg, R. L., & PURPOSe Investigators (2023). Pathogens identified in the internal tissues and placentas of stillbirths: Results from the prospective, observational PURPOSe study. BJOG: An International Journal of Obstetrics and Gynaecology, 130(10), 1238-1246. https://doi.org/10.1111/1471-0528.17479
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.
