Fichorova, R.N., Onderdonk, A.B., Yamamoto, H., Delaney, M.L., DuBois, A.M., Allred, E., Levition, A; for the ELGAN Study Investigators.
The fetal response to intrauterine inflammatory stimuli appears to contribute to the onset of preterm labor as well as
fetal injury, especially affecting newborns of extremely low gestational age. To investigate the role of placental colonization by
specific groups of microorganisms in the development of inflammatory responses present at birth, we analyzed 25 protein biomarkers
in dry blood spots obtained from 527 newborns delivered by Caesarean section in the 23rd to 27th gestation weeks. Bacteria
were detected in placentas and characterized by culture techniques. Odds ratios for having protein concentrations in the
top quartile for gestation age for individual and groups of microorganisms were calculated. Mixed bacterial vaginosis (BV) organisms
were associated with a proinflammatory pattern similar to those of infectious facultative anaerobes. Prevotella and
Gardnerella species, anaerobic streptococci, peptostreptococci, and genital mycoplasmas each appeared to be associated with a
different pattern of elevated blood levels of inflammation-related proteins. Lactobacillus was associated with low odds of an inflammatory
response. This study provides evidence that microorganisms colonizing the placenta provoke distinctive newborn
inflammatory responses and that Lactobacillus may suppress these responses.