Prevalence and Diversity of Microbes in the Amniotic Fluid, the Fetal Inflammatory Response, and Pregnancy Outcome in Women with Preterm Pre-Labor Rupture of Membranes
Citation DiGiulio DB, Romero R, Kusanovic JP, Gómez R, Kim CJ, Seok K, Gotsch F, Mazaki‐Tovi S, Vaisbuch E, Sanders K, Bik EM, Chaiworapongsa T, Oyarzún E, Relman DA. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with pret...
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| creator | DiGiulio, Daniel B. Romero, Roberto Kusanovic, Juan Pedro Gómez, Ricardo Kim, Chong Jai Seok, Kimberley S. Gotsch, Francesca Mazaki-Tovi, Shali Vaisbuch, Edi Sanders, Katherine Bik, Elisabeth M. Chaiworapongsa, Tinnakorn Oyarzún, Enrique Relman, David A. |
| description | Citation DiGiulio DB, Romero R, Kusanovic JP, Gómez R, Kim CJ, Seok K, Gotsch F, Mazaki‐Tovi S, Vaisbuch E, Sanders K, Bik EM, Chaiworapongsa T, Oyarzún E, Relman DA. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre‐labor rupture of membranes. Am J Reprod Immunol 2010; 64: 38–57
Problem The role played by microbial invasion of the amniotic cavity (MIAC) in preterm pre‐labor rupture of membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation‐based methods.
Method of study Amniotic fluid from 204 subjects with pPROM was analyzed with both cultivation and molecular methods in a retrospective cohort study. Broad‐range and group‐specific polymerase chain reaction (PCR) assays targeted small subunit ribosomal DNA (rDNA), or other gene sequences, from bacteria, fungi, and archaea. Results were correlated with measurements of host inflammation, as well as pregnancy and perinatal outcomes.
Results The prevalence of MIAC was 34% (70/204) by culture, 45% (92/204) by PCR, and 50% (101/204) by both methods combined. The number of bacterial species revealed by PCR (44 species‐level phylotypes) was greater than that by culture (14 species) and included as‐yet uncultivated taxa. Some taxa detected by PCR have been previously associated with the gastrointestinal tract (e.g., Coprobacillus sp.), the mouth (e.g., Rothia dentocariosa), or the vagina in the setting of bacterial vaginosis (e.g., Atopobium vaginae). The relative risk for histologic chorioamnionitis was 2.1 for a positive PCR [95% confidence interval (CI), 1.4–3.0] and 2.0 for a positive culture (95% CI, 1.4–2.7). Bacterial rDNA abundance exhibited a dose relationship with gestational age at delivery (R2 = 0.26; P |
| doi_str_mv | 10.1111/j.1600-0897.2010.00830.x |
| format | Article |
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Problem The role played by microbial invasion of the amniotic cavity (MIAC) in preterm pre‐labor rupture of membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation‐based methods.
Method of study Amniotic fluid from 204 subjects with pPROM was analyzed with both cultivation and molecular methods in a retrospective cohort study. Broad‐range and group‐specific polymerase chain reaction (PCR) assays targeted small subunit ribosomal DNA (rDNA), or other gene sequences, from bacteria, fungi, and archaea. Results were correlated with measurements of host inflammation, as well as pregnancy and perinatal outcomes.
Results The prevalence of MIAC was 34% (70/204) by culture, 45% (92/204) by PCR, and 50% (101/204) by both methods combined. The number of bacterial species revealed by PCR (44 species‐level phylotypes) was greater than that by culture (14 species) and included as‐yet uncultivated taxa. Some taxa detected by PCR have been previously associated with the gastrointestinal tract (e.g., Coprobacillus sp.), the mouth (e.g., Rothia dentocariosa), or the vagina in the setting of bacterial vaginosis (e.g., Atopobium vaginae). The relative risk for histologic chorioamnionitis was 2.1 for a positive PCR [95% confidence interval (CI), 1.4–3.0] and 2.0 for a positive culture (95% CI, 1.4–2.7). Bacterial rDNA abundance exhibited a dose relationship with gestational age at delivery (R2 = 0.26; P < 0.01). A positive PCR was associated with lower mean birthweight, and with higher rates of respiratory distress syndrome and necrotizing enterocolitis (P < 0.05 for each outcome).
Conclusion MIAC in pPROM is more common than previously recognized and is associated in some cases with uncultivated taxa, some of which are typically associated with the gastrointestinal tract. The detection of MIAC by molecular methods has clinical significance.</description><identifier>ISSN: 1046-7408</identifier><identifier>EISSN: 1600-0897</identifier><identifier>DOI: 10.1111/j.1600-0897.2010.00830.x</identifier><identifier>PMID: 20331587</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>16S ; Abundance ; Adult ; Amniotic fluid ; Amniotic Fluid - microbiology ; Archaea ; Atopobium vaginae ; Birth weight ; Cavities ; Chorioamnionitis ; Chorioamnionitis - microbiology ; cytokines ; Dopamine ; Female ; fetal inflammatory response syndrome ; Fetal Membranes, Premature Rupture - microbiology ; Fetuses ; Fungi ; Gastrointestinal tract ; Gestational age ; Humans ; Inflammation ; interleukin-6 ; intraamniotic infection ; intraamniotic inflammation ; molecular microbiology ; Mouth ; Necrotizing enterocolitis ; Nucleotide sequence ; Phylogeny ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious - microbiology ; Pregnancy Outcome ; preterm birth ; preterm delivery ; preterm pre-labor rupture of membrane ; rDNA ; Respiratory distress syndrome ; Risk assessment ; Rothia dentocariosa ; Rupture ; Vagina ; Vaginosis ; Vaginosis, Bacterial - microbiology</subject><ispartof>American journal of reproductive immunology (1989), 2010-07, Vol.64 (1), p.38-57</ispartof><rights>Published 2010. This article is a US Government work and is in the public domain in the USA.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4020-430ffeb709d2159954da79e3c22fe4359c4717a3f15bea1b3f270444b401959e3</citedby><cites>FETCH-LOGICAL-c4020-430ffeb709d2159954da79e3c22fe4359c4717a3f15bea1b3f270444b401959e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1600-0897.2010.00830.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1600-0897.2010.00830.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20331587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DiGiulio, Daniel B.</creatorcontrib><creatorcontrib>Romero, Roberto</creatorcontrib><creatorcontrib>Kusanovic, Juan Pedro</creatorcontrib><creatorcontrib>Gómez, Ricardo</creatorcontrib><creatorcontrib>Kim, Chong Jai</creatorcontrib><creatorcontrib>Seok, Kimberley S.</creatorcontrib><creatorcontrib>Gotsch, Francesca</creatorcontrib><creatorcontrib>Mazaki-Tovi, Shali</creatorcontrib><creatorcontrib>Vaisbuch, Edi</creatorcontrib><creatorcontrib>Sanders, Katherine</creatorcontrib><creatorcontrib>Bik, Elisabeth M.</creatorcontrib><creatorcontrib>Chaiworapongsa, Tinnakorn</creatorcontrib><creatorcontrib>Oyarzún, Enrique</creatorcontrib><creatorcontrib>Relman, David A.</creatorcontrib><title>Prevalence and Diversity of Microbes in the Amniotic Fluid, the Fetal Inflammatory Response, and Pregnancy Outcome in Women with Preterm Pre-Labor Rupture of Membranes</title><title>American journal of reproductive immunology (1989)</title><addtitle>Am J Reprod Immunol</addtitle><description>Citation DiGiulio DB, Romero R, Kusanovic JP, Gómez R, Kim CJ, Seok K, Gotsch F, Mazaki‐Tovi S, Vaisbuch E, Sanders K, Bik EM, Chaiworapongsa T, Oyarzún E, Relman DA. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre‐labor rupture of membranes. Am J Reprod Immunol 2010; 64: 38–57
Problem The role played by microbial invasion of the amniotic cavity (MIAC) in preterm pre‐labor rupture of membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation‐based methods.
Method of study Amniotic fluid from 204 subjects with pPROM was analyzed with both cultivation and molecular methods in a retrospective cohort study. Broad‐range and group‐specific polymerase chain reaction (PCR) assays targeted small subunit ribosomal DNA (rDNA), or other gene sequences, from bacteria, fungi, and archaea. Results were correlated with measurements of host inflammation, as well as pregnancy and perinatal outcomes.
Results The prevalence of MIAC was 34% (70/204) by culture, 45% (92/204) by PCR, and 50% (101/204) by both methods combined. The number of bacterial species revealed by PCR (44 species‐level phylotypes) was greater than that by culture (14 species) and included as‐yet uncultivated taxa. Some taxa detected by PCR have been previously associated with the gastrointestinal tract (e.g., Coprobacillus sp.), the mouth (e.g., Rothia dentocariosa), or the vagina in the setting of bacterial vaginosis (e.g., Atopobium vaginae). The relative risk for histologic chorioamnionitis was 2.1 for a positive PCR [95% confidence interval (CI), 1.4–3.0] and 2.0 for a positive culture (95% CI, 1.4–2.7). Bacterial rDNA abundance exhibited a dose relationship with gestational age at delivery (R2 = 0.26; P < 0.01). A positive PCR was associated with lower mean birthweight, and with higher rates of respiratory distress syndrome and necrotizing enterocolitis (P < 0.05 for each outcome).
Conclusion MIAC in pPROM is more common than previously recognized and is associated in some cases with uncultivated taxa, some of which are typically associated with the gastrointestinal tract. The detection of MIAC by molecular methods has clinical significance.</description><subject>16S</subject><subject>Abundance</subject><subject>Adult</subject><subject>Amniotic fluid</subject><subject>Amniotic Fluid - microbiology</subject><subject>Archaea</subject><subject>Atopobium vaginae</subject><subject>Birth weight</subject><subject>Cavities</subject><subject>Chorioamnionitis</subject><subject>Chorioamnionitis - microbiology</subject><subject>cytokines</subject><subject>Dopamine</subject><subject>Female</subject><subject>fetal inflammatory response syndrome</subject><subject>Fetal Membranes, Premature Rupture - microbiology</subject><subject>Fetuses</subject><subject>Fungi</subject><subject>Gastrointestinal tract</subject><subject>Gestational age</subject><subject>Humans</subject><subject>Inflammation</subject><subject>interleukin-6</subject><subject>intraamniotic infection</subject><subject>intraamniotic inflammation</subject><subject>molecular microbiology</subject><subject>Mouth</subject><subject>Necrotizing enterocolitis</subject><subject>Nucleotide sequence</subject><subject>Phylogeny</subject><subject>Polymerase Chain Reaction</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Infectious - microbiology</subject><subject>Pregnancy Outcome</subject><subject>preterm birth</subject><subject>preterm delivery</subject><subject>preterm pre-labor rupture of membrane</subject><subject>rDNA</subject><subject>Respiratory distress syndrome</subject><subject>Risk assessment</subject><subject>Rothia dentocariosa</subject><subject>Rupture</subject><subject>Vagina</subject><subject>Vaginosis</subject><subject>Vaginosis, Bacterial - microbiology</subject><issn>1046-7408</issn><issn>1600-0897</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkcFu1DAQhiMEoqXwCsg3Ls3Wjp04lrgshW232m1RBerRcpIJ9ZI4W9tpN0_Ea9bJlr2CL2ONv_-fkf8oQgTPSDhnmxnJMI5xLvgswaGLcU7xbPcqOj48vA53zLKYM5wfRe-c2-BACcrfRkcJppSkOT-O_ny38KgaMCUgZSr0VT-CddoPqKvRWpe2K8AhbZC_BzRvje68LtGi6XV1OvUW4FWDlqZuVNsq39kB3YLbdsbB6eQYBvwyypQDuul92bUwut2FatCT9vfjuwfbjjVeqaKz6Lbf-t7CtAG0hVUG3PvoTa0aBx9e6kn0c_Htx_llvLq5WJ7PV3HJcIJjRnFdQ8GxqBKSCpGySnEBtEySGhhNRck44YrWJC1AkYLWCceMsYJhItIAnkSf9r5b2z304LxstSuhacISXe8kZywjQlD2b5LSNBMJxYHM92T4Tecs1HJrdavsIAmWY55yI8fY5BibHPOUU55yF6QfX4b0RQvVQfg3wAB83gNPuoHhv43l_GqZT6vFe7l2HnYHubK_ZcYpT-Xd9YVcX9P0y9XlWi7oM7zwvig</recordid><startdate>201007</startdate><enddate>201007</enddate><creator>DiGiulio, Daniel B.</creator><creator>Romero, Roberto</creator><creator>Kusanovic, Juan Pedro</creator><creator>Gómez, Ricardo</creator><creator>Kim, Chong Jai</creator><creator>Seok, Kimberley S.</creator><creator>Gotsch, Francesca</creator><creator>Mazaki-Tovi, Shali</creator><creator>Vaisbuch, Edi</creator><creator>Sanders, Katherine</creator><creator>Bik, Elisabeth M.</creator><creator>Chaiworapongsa, Tinnakorn</creator><creator>Oyarzún, Enrique</creator><creator>Relman, David A.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><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>7X8</scope><scope>7T5</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>M7N</scope><scope>P64</scope></search><sort><creationdate>201007</creationdate><title>Prevalence and Diversity of Microbes in the Amniotic Fluid, the Fetal Inflammatory Response, and Pregnancy Outcome in Women with Preterm Pre-Labor Rupture of Membranes</title><author>DiGiulio, Daniel B. ; Romero, Roberto ; Kusanovic, Juan Pedro ; Gómez, Ricardo ; Kim, Chong Jai ; Seok, Kimberley S. ; Gotsch, Francesca ; Mazaki-Tovi, Shali ; Vaisbuch, Edi ; Sanders, Katherine ; Bik, Elisabeth M. ; Chaiworapongsa, Tinnakorn ; Oyarzún, Enrique ; Relman, David A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4020-430ffeb709d2159954da79e3c22fe4359c4717a3f15bea1b3f270444b401959e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>16S</topic><topic>Abundance</topic><topic>Adult</topic><topic>Amniotic fluid</topic><topic>Amniotic Fluid - microbiology</topic><topic>Archaea</topic><topic>Atopobium vaginae</topic><topic>Birth weight</topic><topic>Cavities</topic><topic>Chorioamnionitis</topic><topic>Chorioamnionitis - microbiology</topic><topic>cytokines</topic><topic>Dopamine</topic><topic>Female</topic><topic>fetal inflammatory response syndrome</topic><topic>Fetal Membranes, Premature Rupture - microbiology</topic><topic>Fetuses</topic><topic>Fungi</topic><topic>Gastrointestinal tract</topic><topic>Gestational age</topic><topic>Humans</topic><topic>Inflammation</topic><topic>interleukin-6</topic><topic>intraamniotic infection</topic><topic>intraamniotic inflammation</topic><topic>molecular microbiology</topic><topic>Mouth</topic><topic>Necrotizing enterocolitis</topic><topic>Nucleotide sequence</topic><topic>Phylogeny</topic><topic>Polymerase Chain Reaction</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Infectious - microbiology</topic><topic>Pregnancy Outcome</topic><topic>preterm birth</topic><topic>preterm delivery</topic><topic>preterm pre-labor rupture of membrane</topic><topic>rDNA</topic><topic>Respiratory distress syndrome</topic><topic>Risk assessment</topic><topic>Rothia dentocariosa</topic><topic>Rupture</topic><topic>Vagina</topic><topic>Vaginosis</topic><topic>Vaginosis, Bacterial - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DiGiulio, Daniel B.</creatorcontrib><creatorcontrib>Romero, Roberto</creatorcontrib><creatorcontrib>Kusanovic, Juan Pedro</creatorcontrib><creatorcontrib>Gómez, Ricardo</creatorcontrib><creatorcontrib>Kim, Chong Jai</creatorcontrib><creatorcontrib>Seok, Kimberley S.</creatorcontrib><creatorcontrib>Gotsch, Francesca</creatorcontrib><creatorcontrib>Mazaki-Tovi, Shali</creatorcontrib><creatorcontrib>Vaisbuch, Edi</creatorcontrib><creatorcontrib>Sanders, Katherine</creatorcontrib><creatorcontrib>Bik, Elisabeth M.</creatorcontrib><creatorcontrib>Chaiworapongsa, Tinnakorn</creatorcontrib><creatorcontrib>Oyarzún, Enrique</creatorcontrib><creatorcontrib>Relman, David A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>American journal of reproductive immunology (1989)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DiGiulio, Daniel B.</au><au>Romero, Roberto</au><au>Kusanovic, Juan Pedro</au><au>Gómez, Ricardo</au><au>Kim, Chong Jai</au><au>Seok, Kimberley S.</au><au>Gotsch, Francesca</au><au>Mazaki-Tovi, Shali</au><au>Vaisbuch, Edi</au><au>Sanders, Katherine</au><au>Bik, Elisabeth M.</au><au>Chaiworapongsa, Tinnakorn</au><au>Oyarzún, Enrique</au><au>Relman, David A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and Diversity of Microbes in the Amniotic Fluid, the Fetal Inflammatory Response, and Pregnancy Outcome in Women with Preterm Pre-Labor Rupture of Membranes</atitle><jtitle>American journal of reproductive immunology (1989)</jtitle><addtitle>Am J Reprod Immunol</addtitle><date>2010-07</date><risdate>2010</risdate><volume>64</volume><issue>1</issue><spage>38</spage><epage>57</epage><pages>38-57</pages><issn>1046-7408</issn><eissn>1600-0897</eissn><abstract>Citation DiGiulio DB, Romero R, Kusanovic JP, Gómez R, Kim CJ, Seok K, Gotsch F, Mazaki‐Tovi S, Vaisbuch E, Sanders K, Bik EM, Chaiworapongsa T, Oyarzún E, Relman DA. Prevalence and diversity of microbes in the amniotic fluid, the fetal inflammatory response, and pregnancy outcome in women with preterm pre‐labor rupture of membranes. Am J Reprod Immunol 2010; 64: 38–57
Problem The role played by microbial invasion of the amniotic cavity (MIAC) in preterm pre‐labor rupture of membranes (pPROM) is inadequately characterized, in part because of reliance on cultivation‐based methods.
Method of study Amniotic fluid from 204 subjects with pPROM was analyzed with both cultivation and molecular methods in a retrospective cohort study. Broad‐range and group‐specific polymerase chain reaction (PCR) assays targeted small subunit ribosomal DNA (rDNA), or other gene sequences, from bacteria, fungi, and archaea. Results were correlated with measurements of host inflammation, as well as pregnancy and perinatal outcomes.
Results The prevalence of MIAC was 34% (70/204) by culture, 45% (92/204) by PCR, and 50% (101/204) by both methods combined. The number of bacterial species revealed by PCR (44 species‐level phylotypes) was greater than that by culture (14 species) and included as‐yet uncultivated taxa. Some taxa detected by PCR have been previously associated with the gastrointestinal tract (e.g., Coprobacillus sp.), the mouth (e.g., Rothia dentocariosa), or the vagina in the setting of bacterial vaginosis (e.g., Atopobium vaginae). The relative risk for histologic chorioamnionitis was 2.1 for a positive PCR [95% confidence interval (CI), 1.4–3.0] and 2.0 for a positive culture (95% CI, 1.4–2.7). Bacterial rDNA abundance exhibited a dose relationship with gestational age at delivery (R2 = 0.26; P < 0.01). A positive PCR was associated with lower mean birthweight, and with higher rates of respiratory distress syndrome and necrotizing enterocolitis (P < 0.05 for each outcome).
Conclusion MIAC in pPROM is more common than previously recognized and is associated in some cases with uncultivated taxa, some of which are typically associated with the gastrointestinal tract. The detection of MIAC by molecular methods has clinical significance.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>20331587</pmid><doi>10.1111/j.1600-0897.2010.00830.x</doi><tpages>20</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1046-7408 |
| ispartof | American journal of reproductive immunology (1989), 2010-07, Vol.64 (1), p.38-57 |
| issn | 1046-7408 1600-0897 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_744619934 |
| source | MEDLINE; Wiley Online Library |
| subjects | 16S Abundance Adult Amniotic fluid Amniotic Fluid - microbiology Archaea Atopobium vaginae Birth weight Cavities Chorioamnionitis Chorioamnionitis - microbiology cytokines Dopamine Female fetal inflammatory response syndrome Fetal Membranes, Premature Rupture - microbiology Fetuses Fungi Gastrointestinal tract Gestational age Humans Inflammation interleukin-6 intraamniotic infection intraamniotic inflammation molecular microbiology Mouth Necrotizing enterocolitis Nucleotide sequence Phylogeny Polymerase Chain Reaction Pregnancy Pregnancy Complications, Infectious - microbiology Pregnancy Outcome preterm birth preterm delivery preterm pre-labor rupture of membrane rDNA Respiratory distress syndrome Risk assessment Rothia dentocariosa Rupture Vagina Vaginosis Vaginosis, Bacterial - microbiology |
| title | Prevalence and Diversity of Microbes in the Amniotic Fluid, the Fetal Inflammatory Response, and Pregnancy Outcome in Women with Preterm Pre-Labor Rupture of Membranes |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T15%3A24%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Prevalence%20and%20Diversity%20of%20Microbes%20in%20the%20Amniotic%20Fluid,%20the%20Fetal%20Inflammatory%20Response,%20and%20Pregnancy%20Outcome%20in%20Women%20with%20Preterm%20Pre-Labor%20Rupture%20of%20Membranes&rft.jtitle=American%20journal%20of%20reproductive%20immunology%20(1989)&rft.au=DiGiulio,%20Daniel%20B.&rft.date=2010-07&rft.volume=64&rft.issue=1&rft.spage=38&rft.epage=57&rft.pages=38-57&rft.issn=1046-7408&rft.eissn=1600-0897&rft_id=info:doi/10.1111/j.1600-0897.2010.00830.x&rft_dat=%3Cproquest_cross%3E744619934%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=733569230&rft_id=info:pmid/20331587&rfr_iscdi=true |