Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants
Background The long‐term follow‐up of lung function (LF) in extremely preterm (EP) infants with bronchopulmonary dysplasia (BPD) has shown a worldwide increase in small airway obstructions (SAO). Objectives We investigated the relationships between intrauterine Ureplasma infection in EP infants and...
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| Veröffentlicht in: | Pediatric pulmonology 2022-11, Vol.57 (11), p.2763-2773 |
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| creator | Kitajima, Hiroyuki Fujimura, Masanori Takeuchi, Makoto Kawamoto, Yutaka Sumi, Kiyoaki Matsunami, Katsura Shiraishi, Jun Hirano, Shinya Nakura, Yukiko Yanagihara, Itaru |
| description | Background
The long‐term follow‐up of lung function (LF) in extremely preterm (EP) infants with bronchopulmonary dysplasia (BPD) has shown a worldwide increase in small airway obstructions (SAO).
Objectives
We investigated the relationships between intrauterine Ureplasma infection in EP infants and bubbly/cystic lung, BPD, and SAO at school age.
Methods
Placental pathology, placental Ureaplasma DNA (pU‐DNA), and cord blood immunoglobulin M (IgM) (C‐IgM) were investigated in 360 EP infants born from 1981 to 2004. Maternal amniotic inflammatory response (M‐AIR) scores and hemosiderin deposition (HD) were estimated in the chorioamnion. The study subjects were divided into groups based on their M‐AIR scores. Their LF at school age was compared with those of 33 healthy siblings.
Findings
pU‐DNA and C‐IgM were significantly related to SAO at school age (p 1000 units had an odds ratio (OR) of 35 (95% confidence interval: 10–172) and 18 (5.6–67) for bubbly/cystic lung, and 11 (3.1 − 43) and 31 (4.5–349) for severe BPD, and 5.3 (2.1–11) and 12 (2.4–74) for SAO, respectively. The ORs of surfactant treatment, BPD grade III, O2 at 40 weeks, HD, and C‐IgM >30 mg/dl for SAO were 0.21 (0.075–0.58), 5.3 (2.1–15), 2.5 (1.4–4.6), 3.6 (1.5–9.1) and 2.5 (1.0–5.2). 84% (90/107) SAO infants showed no or mild BPD in infancy, and 61% of infants had no severe CAM.
Conclusion
Our long‐term cohort study of LF in EP infants revealed that intrauterine Ureaplasma was associated with bubbly/cystic lung, severe BPD, and SAO at school age. |
| doi_str_mv | 10.1002/ppul.26098 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2699706306</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2725175599</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3578-9c505131d9fcf908173a32e627168bfdcb11fd8082644b6f730ecf8e1ef6e65d3</originalsourceid><addsrcrecordid>eNp9kMtqGzEUQEVJaBy3m3xAEGQTCpPo4dFIyxKaJmCIF_Fa1WiuqILmUUmD67-PXKdddBG4ILg6HC4HoQtKbigh7Haa5nDDBFHyA1pQolRFVkqcoIVs6roSUvAzdJ7SCyHlT9GP6IzXilPFVgv043HI0cwZoh8AbyOYKZjUG-wTNimN1psMHd75_BOXdQjY-Lgzezy2KcfZZj8O2A8YfucIPYQ9niIUW1-Wzgw5fUKnzoQEn9_eJdref3u-e6jWT98f776uK8vrRlbK1qSmnHbKWaeIpA03nIFgDRWydZ1tKXWdJJKJ1aoVruEErJNAwQkQdceX6ProneL4a4aUde-ThRDMAOOcNBNKNUTwMkt09R_6Ms5xKNdp1rCalmpKFerLkbJxTCmC01P0vYl7TYk-dNeH7vpP9wJfvinntofuH_o3dAHoEdj5APt3VHqz2a6P0ldqg48V</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2725175599</pqid></control><display><type>article</type><title>Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Kitajima, Hiroyuki ; Fujimura, Masanori ; Takeuchi, Makoto ; Kawamoto, Yutaka ; Sumi, Kiyoaki ; Matsunami, Katsura ; Shiraishi, Jun ; Hirano, Shinya ; Nakura, Yukiko ; Yanagihara, Itaru</creator><creatorcontrib>Kitajima, Hiroyuki ; Fujimura, Masanori ; Takeuchi, Makoto ; Kawamoto, Yutaka ; Sumi, Kiyoaki ; Matsunami, Katsura ; Shiraishi, Jun ; Hirano, Shinya ; Nakura, Yukiko ; Yanagihara, Itaru</creatorcontrib><description>Background
The long‐term follow‐up of lung function (LF) in extremely preterm (EP) infants with bronchopulmonary dysplasia (BPD) has shown a worldwide increase in small airway obstructions (SAO).
Objectives
We investigated the relationships between intrauterine Ureplasma infection in EP infants and bubbly/cystic lung, BPD, and SAO at school age.
Methods
Placental pathology, placental Ureaplasma DNA (pU‐DNA), and cord blood immunoglobulin M (IgM) (C‐IgM) were investigated in 360 EP infants born from 1981 to 2004. Maternal amniotic inflammatory response (M‐AIR) scores and hemosiderin deposition (HD) were estimated in the chorioamnion. The study subjects were divided into groups based on their M‐AIR scores. Their LF at school age was compared with those of 33 healthy siblings.
Findings
pU‐DNA and C‐IgM were significantly related to SAO at school age (p < 0.012). M‐AIR score 3 and pU‐DNA >1000 units had an odds ratio (OR) of 35 (95% confidence interval: 10–172) and 18 (5.6–67) for bubbly/cystic lung, and 11 (3.1 − 43) and 31 (4.5–349) for severe BPD, and 5.3 (2.1–11) and 12 (2.4–74) for SAO, respectively. The ORs of surfactant treatment, BPD grade III, O2 at 40 weeks, HD, and C‐IgM >30 mg/dl for SAO were 0.21 (0.075–0.58), 5.3 (2.1–15), 2.5 (1.4–4.6), 3.6 (1.5–9.1) and 2.5 (1.0–5.2). 84% (90/107) SAO infants showed no or mild BPD in infancy, and 61% of infants had no severe CAM.
Conclusion
Our long‐term cohort study of LF in EP infants revealed that intrauterine Ureaplasma was associated with bubbly/cystic lung, severe BPD, and SAO at school age.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.26098</identifier><identifier>PMID: 35931924</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Airway management ; Airway Obstruction ; bronchopulmonary dysplasia ; Bronchopulmonary Dysplasia - complications ; bubbly/cystic lung ; Cohort Studies ; extremely preterm infant ; Female ; Gestational Age ; Hemosiderin ; Humans ; Immunoglobulin M ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Placenta ; Pregnancy ; small airway obstruction ; Surface-Active Agents ; Ureaplasma</subject><ispartof>Pediatric pulmonology, 2022-11, Vol.57 (11), p.2763-2773</ispartof><rights>2022 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3578-9c505131d9fcf908173a32e627168bfdcb11fd8082644b6f730ecf8e1ef6e65d3</citedby><cites>FETCH-LOGICAL-c3578-9c505131d9fcf908173a32e627168bfdcb11fd8082644b6f730ecf8e1ef6e65d3</cites><orcidid>0000-0001-9882-8196</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.26098$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.26098$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35931924$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kitajima, Hiroyuki</creatorcontrib><creatorcontrib>Fujimura, Masanori</creatorcontrib><creatorcontrib>Takeuchi, Makoto</creatorcontrib><creatorcontrib>Kawamoto, Yutaka</creatorcontrib><creatorcontrib>Sumi, Kiyoaki</creatorcontrib><creatorcontrib>Matsunami, Katsura</creatorcontrib><creatorcontrib>Shiraishi, Jun</creatorcontrib><creatorcontrib>Hirano, Shinya</creatorcontrib><creatorcontrib>Nakura, Yukiko</creatorcontrib><creatorcontrib>Yanagihara, Itaru</creatorcontrib><title>Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>Background
The long‐term follow‐up of lung function (LF) in extremely preterm (EP) infants with bronchopulmonary dysplasia (BPD) has shown a worldwide increase in small airway obstructions (SAO).
Objectives
We investigated the relationships between intrauterine Ureplasma infection in EP infants and bubbly/cystic lung, BPD, and SAO at school age.
Methods
Placental pathology, placental Ureaplasma DNA (pU‐DNA), and cord blood immunoglobulin M (IgM) (C‐IgM) were investigated in 360 EP infants born from 1981 to 2004. Maternal amniotic inflammatory response (M‐AIR) scores and hemosiderin deposition (HD) were estimated in the chorioamnion. The study subjects were divided into groups based on their M‐AIR scores. Their LF at school age was compared with those of 33 healthy siblings.
Findings
pU‐DNA and C‐IgM were significantly related to SAO at school age (p < 0.012). M‐AIR score 3 and pU‐DNA >1000 units had an odds ratio (OR) of 35 (95% confidence interval: 10–172) and 18 (5.6–67) for bubbly/cystic lung, and 11 (3.1 − 43) and 31 (4.5–349) for severe BPD, and 5.3 (2.1–11) and 12 (2.4–74) for SAO, respectively. The ORs of surfactant treatment, BPD grade III, O2 at 40 weeks, HD, and C‐IgM >30 mg/dl for SAO were 0.21 (0.075–0.58), 5.3 (2.1–15), 2.5 (1.4–4.6), 3.6 (1.5–9.1) and 2.5 (1.0–5.2). 84% (90/107) SAO infants showed no or mild BPD in infancy, and 61% of infants had no severe CAM.
Conclusion
Our long‐term cohort study of LF in EP infants revealed that intrauterine Ureaplasma was associated with bubbly/cystic lung, severe BPD, and SAO at school age.</description><subject>Airway management</subject><subject>Airway Obstruction</subject><subject>bronchopulmonary dysplasia</subject><subject>Bronchopulmonary Dysplasia - complications</subject><subject>bubbly/cystic lung</subject><subject>Cohort Studies</subject><subject>extremely preterm infant</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Hemosiderin</subject><subject>Humans</subject><subject>Immunoglobulin M</subject><subject>Infant</subject><subject>Infant, Extremely Premature</subject><subject>Infant, Newborn</subject><subject>Placenta</subject><subject>Pregnancy</subject><subject>small airway obstruction</subject><subject>Surface-Active Agents</subject><subject>Ureaplasma</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtqGzEUQEVJaBy3m3xAEGQTCpPo4dFIyxKaJmCIF_Fa1WiuqILmUUmD67-PXKdddBG4ILg6HC4HoQtKbigh7Haa5nDDBFHyA1pQolRFVkqcoIVs6roSUvAzdJ7SCyHlT9GP6IzXilPFVgv043HI0cwZoh8AbyOYKZjUG-wTNimN1psMHd75_BOXdQjY-Lgzezy2KcfZZj8O2A8YfucIPYQ9niIUW1-Wzgw5fUKnzoQEn9_eJdref3u-e6jWT98f776uK8vrRlbK1qSmnHbKWaeIpA03nIFgDRWydZ1tKXWdJJKJ1aoVruEErJNAwQkQdceX6ProneL4a4aUde-ThRDMAOOcNBNKNUTwMkt09R_6Ms5xKNdp1rCalmpKFerLkbJxTCmC01P0vYl7TYk-dNeH7vpP9wJfvinntofuH_o3dAHoEdj5APt3VHqz2a6P0ldqg48V</recordid><startdate>202211</startdate><enddate>202211</enddate><creator>Kitajima, Hiroyuki</creator><creator>Fujimura, Masanori</creator><creator>Takeuchi, Makoto</creator><creator>Kawamoto, Yutaka</creator><creator>Sumi, Kiyoaki</creator><creator>Matsunami, Katsura</creator><creator>Shiraishi, Jun</creator><creator>Hirano, Shinya</creator><creator>Nakura, Yukiko</creator><creator>Yanagihara, Itaru</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9882-8196</orcidid></search><sort><creationdate>202211</creationdate><title>Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants</title><author>Kitajima, Hiroyuki ; Fujimura, Masanori ; Takeuchi, Makoto ; Kawamoto, Yutaka ; Sumi, Kiyoaki ; Matsunami, Katsura ; Shiraishi, Jun ; Hirano, Shinya ; Nakura, Yukiko ; Yanagihara, Itaru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3578-9c505131d9fcf908173a32e627168bfdcb11fd8082644b6f730ecf8e1ef6e65d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Airway management</topic><topic>Airway Obstruction</topic><topic>bronchopulmonary dysplasia</topic><topic>Bronchopulmonary Dysplasia - complications</topic><topic>bubbly/cystic lung</topic><topic>Cohort Studies</topic><topic>extremely preterm infant</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Hemosiderin</topic><topic>Humans</topic><topic>Immunoglobulin M</topic><topic>Infant</topic><topic>Infant, Extremely Premature</topic><topic>Infant, Newborn</topic><topic>Placenta</topic><topic>Pregnancy</topic><topic>small airway obstruction</topic><topic>Surface-Active Agents</topic><topic>Ureaplasma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kitajima, Hiroyuki</creatorcontrib><creatorcontrib>Fujimura, Masanori</creatorcontrib><creatorcontrib>Takeuchi, Makoto</creatorcontrib><creatorcontrib>Kawamoto, Yutaka</creatorcontrib><creatorcontrib>Sumi, Kiyoaki</creatorcontrib><creatorcontrib>Matsunami, Katsura</creatorcontrib><creatorcontrib>Shiraishi, Jun</creatorcontrib><creatorcontrib>Hirano, Shinya</creatorcontrib><creatorcontrib>Nakura, Yukiko</creatorcontrib><creatorcontrib>Yanagihara, Itaru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kitajima, Hiroyuki</au><au>Fujimura, Masanori</au><au>Takeuchi, Makoto</au><au>Kawamoto, Yutaka</au><au>Sumi, Kiyoaki</au><au>Matsunami, Katsura</au><au>Shiraishi, Jun</au><au>Hirano, Shinya</au><au>Nakura, Yukiko</au><au>Yanagihara, Itaru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2022-11</date><risdate>2022</risdate><volume>57</volume><issue>11</issue><spage>2763</spage><epage>2773</epage><pages>2763-2773</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>Background
The long‐term follow‐up of lung function (LF) in extremely preterm (EP) infants with bronchopulmonary dysplasia (BPD) has shown a worldwide increase in small airway obstructions (SAO).
Objectives
We investigated the relationships between intrauterine Ureplasma infection in EP infants and bubbly/cystic lung, BPD, and SAO at school age.
Methods
Placental pathology, placental Ureaplasma DNA (pU‐DNA), and cord blood immunoglobulin M (IgM) (C‐IgM) were investigated in 360 EP infants born from 1981 to 2004. Maternal amniotic inflammatory response (M‐AIR) scores and hemosiderin deposition (HD) were estimated in the chorioamnion. The study subjects were divided into groups based on their M‐AIR scores. Their LF at school age was compared with those of 33 healthy siblings.
Findings
pU‐DNA and C‐IgM were significantly related to SAO at school age (p < 0.012). M‐AIR score 3 and pU‐DNA >1000 units had an odds ratio (OR) of 35 (95% confidence interval: 10–172) and 18 (5.6–67) for bubbly/cystic lung, and 11 (3.1 − 43) and 31 (4.5–349) for severe BPD, and 5.3 (2.1–11) and 12 (2.4–74) for SAO, respectively. The ORs of surfactant treatment, BPD grade III, O2 at 40 weeks, HD, and C‐IgM >30 mg/dl for SAO were 0.21 (0.075–0.58), 5.3 (2.1–15), 2.5 (1.4–4.6), 3.6 (1.5–9.1) and 2.5 (1.0–5.2). 84% (90/107) SAO infants showed no or mild BPD in infancy, and 61% of infants had no severe CAM.
Conclusion
Our long‐term cohort study of LF in EP infants revealed that intrauterine Ureaplasma was associated with bubbly/cystic lung, severe BPD, and SAO at school age.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35931924</pmid><doi>10.1002/ppul.26098</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-9882-8196</orcidid></addata></record> |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | Airway management Airway Obstruction bronchopulmonary dysplasia Bronchopulmonary Dysplasia - complications bubbly/cystic lung Cohort Studies extremely preterm infant Female Gestational Age Hemosiderin Humans Immunoglobulin M Infant Infant, Extremely Premature Infant, Newborn Placenta Pregnancy small airway obstruction Surface-Active Agents Ureaplasma |
| title | Intrauterine Ureaplasma is associated with small airway obstruction in extremely preterm infants |
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