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Biomedical subjects

Anna Alanen

Publications and source records attributed to Anna Alanen.

6 recordsLinked to original sources

Ureaplasma urealyticum: no independent role in the pathogenesis of bronchopulmonary dysplasia.

BACKGROUND: Ureaplasma urealyticum has been linked to short and long-term morbidity of preterm infants. We wanted to analyze if it has an independent role in the pathogenesis of bronchopulmonary dysplasia if prenatal history with possible exposure to intrauterine infection is taken into account. METHODS: Lower respiratory tract colonization with U. urealyticum was analyzed from 49 infants born before the 30th week of gestation. The need for supplemental oxygen at the age of 28 days and 36 gestational weeks was studied. RESULTS: Forty-five percent of the 33 infants born after spontaneous onset of labor were colonized with U. urealyticum, while none of the electively born were. If analyzed based on the Ureaplasma colonization, bronchopulmonary dysplasia was more common in the colonized infants at the age of 28 days (OR 4.57, 95% CI 1.18-17.68), but not at the gestational age of 36 weeks (OR 1.00). Based on the prenatal history, the OR of bronchopulmonary dysplasia in infants born after spontaneous onset of labor was greater than in infants born electively both at the age of 28 days (OR 4.33, 95% CI 0.83-22.75) and at 36 weeks of gestation (OR 2.8, 95% CI 0.30-26.42). CONCLUSIONS: If possible exposure to intra-amniotic inflammation is taken into account, U. urealyticum seems not to have an independent role in the pathogenesis of bronchopulmonary dysplasia. Its role has been overemphasized, as it is the most common cause of intra-amniotic bacterial infection.

Bronchopulmonary Dysplasia↗

Transfer of proinflammatory cytokines across term placenta.

OBJECTIVE: Increased concentrations of proinflammatory cytokines in amniotic fluid indicate the presence of intra-amniotic inflammation and increase the risk of preterm birth, cerebral palsy, and bronchopulmonary dysplasia. The purpose of this study was to find out if the proinflammatory cytokines, tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-1beta, and IL-6, transfer across the placenta, and thereby determine whether intra-amniotic inflammatory response, measured from the amniotic fluid, is of maternal or fetal origin. METHODS: Nineteen placentas from healthy women undergoing elective cesarean delivery at term with intact membranes and without labor, were dually perfused ex vivo in an open circulation system for either 30 minutes or 2 hours. Tumor necrosis factor-alpha, IL-1beta, and IL-6 were added to maternal or fetal circulation in a concentration usually found in chorioamnionitis. As a reference, placentas without added cytokine were also perfused. The concentrations of cytokines were determined by enzyme immunoassays (enzyme-linked immunosorbent assay [ELISA]). RESULTS: After the addition of the cytokine to the arterial perfusate, the venous concentration on the same side of the placenta increased rapidly and reached a plateau at 10 minutes. No transfer of any cytokine in either direction was detected. Some endogenous release of IL-6 was observed in response to the perfusion. CONCLUSION: Proinflammatory cytokines do not cross normal term placenta.

Adult↗

Seroprevalence, incidence of prenatal infections and reliability of maternal history of varicella zoster virus, cytomegalovirus, herpes simplex virus and parvovirus B19 infection in South-Western Finland.

OBJECTIVE: To study seroprevalence and incidence and fetal transmission of varicella zoster virus (VZV), cytomegalovirus (CMV), herpes simplex virus (HSV) types 1 and 2 and parvovirus B19 infections during pregnancy and to evaluate the reliability of maternal past history of VZV, HSV and parvovirus infections. DESIGN: Prospective study of parturient women. SETTING: South-Western Finland. PARTICIPANTS: Five hundred and fifty-eight parturient women. METHODS: IgG and IgM antibodies against VZV, CMV, HSV-1 and -2, and parvovirus B19 were measured from maternal serum in the first trimester and at delivery and from cord serum, mother's own information of her past infections was compared with her serological status. MAIN OUTCOME MEASURES: Seroprevalence, seroconversions and fetal transmission of VZV, CMV, HSV and parvovirus B19, reliability of maternal history of VZV, HSV and parvovirus B19. RESULTS: Seroprevalences were 96.2% for VZV, 56.3% for CMV, 54.3% for HSV, 46.8% for HSV-1, 9.3% for HSV-2 and 58.6% for parvovirus B19. Parity was associated with CMV seropositivity, maternal age differed only between HSV-2 seropositive and seronegative women, while area of residence (urban or rural) had no effect. Six seroconversions were observed: two VZV, one CMV and three parvovirus infections. No cases of primary HSV infections occurred. Fetal transmission was observed in two cases of parvovirus infection. No infants with anti-CMV IgM antibodies were born to CMV immunised women. False positive history of chickenpox was given only by 1.5% of the women, history of herpes infections was less reliable, and history of parvovirus infection was unreliable. CONCLUSIONS: Seroprevalence and the risk of viral infections during pregnancy cannot be extrapolated from one pregnant population to another.

Adolescent↗

Cervical ureaplasma urealyticum colonization: comparison of PCR and culture for its detection and association with preterm birth.

We developed a 16S ribosomal (r) RNA gene-based PCR assay specific for Ureaplasma urealyticum and compared it with culture. We also wanted to assess the role of cervical U. urealyticum colonization in preterm births. Cervical swabs from 100 women with preterm contractions and from 50 asymptomatic pregnant women were collected and analyzed using PCR. The PCR and culture methods were compared using the samples from the asymptomatic patients. PCR and culture were equally effective at detecting U. urealyticum. Cervical colonization correlated with preterm delivery, with rates of 71% and 37% for those delivering preterm and those with term delivery, respectively (p = 0.008). The relative risk of preterm delivery if colonized with U. urealyticum was 3.34. 16S rRNA gene-based PCR proved to be a useful tool for detecting U. urealyticum compared to culture. Lower genital tract colonization with U. urealyticum was associated with preterm birth.

Bacteriological Techniques↗