Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study
Background: Although several conditions and specific risk factors have been associated with stillbirth (SB), in most of the cases it is difficult to identify the definitive etiopathology and cause of death. Specifically, the role of infections in SB is still debated. Our aim was to study maternal, p...
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2025-01-01
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| author | Liliana Gabrielli Matteo Pavoni Francesca Monari Federico Baiesi Pillastrini Maria Paola Bonasoni Chiara Locatelli Maria Bisulli Alessandra Vancini Ilaria Cataneo Margherita Ortalli Giulia Piccirilli Alessia Cantiani Simone Ambretti Fabio Facchinetti Tiziana Lazzarotto |
| author_facet | Liliana Gabrielli Matteo Pavoni Francesca Monari Federico Baiesi Pillastrini Maria Paola Bonasoni Chiara Locatelli Maria Bisulli Alessandra Vancini Ilaria Cataneo Margherita Ortalli Giulia Piccirilli Alessia Cantiani Simone Ambretti Fabio Facchinetti Tiziana Lazzarotto |
| author_sort | Liliana Gabrielli |
| collection | DOAJ |
| description | Background: Although several conditions and specific risk factors have been associated with stillbirth (SB), in most of the cases it is difficult to identify the definitive etiopathology and cause of death. Specifically, the role of infections in SB is still debated. Our aim was to study maternal, placental, and fetal tissues in cases of SB in order to define the causative link between infections and fetal death, through a multidisciplinary clinical audit. Methods: Between 2014 and 2022, microbiological investigations on maternal, placental and fetal samples of SB cases were performed according to a standardized protocol including serology, cultures, and molecular biology. Autopsies and placental examination were mandatory in all SB cases. Results: A total of 182 cases of SB were investigated. Bacteria were detected in 22.2% of vaginal swabs, 65% of placental biopsies, 29% of fetal blood, and 14.1% of oropharyngeal swabs. Vaginal and oropharyngeal swabs were positive for urogenital mycoplasmas in 25.2% and 8.6%, respectively. Positive results of microbiological investigations, in association with histological features suggestive of infection, were observed in six cases, indicating that fetal death was likely related to a bacterial infection. In one case, a high SARS-CoV-2 load was found in the placenta of a SB due to placental abruption. Conclusions: Infections were likely associated with fetal death in 3.8% of cases. Thus, in developed countries, an infection, defined when positive microbiological findings are associated with histological evidence of organ damage, is a minor contributory factor in SB. |
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| institution | Kabale University |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
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| series | Microorganisms |
| spelling | doaj-art-3e14d839aacc40b4a7d0fdb3973b91b42025-01-24T13:42:32ZengMDPI AGMicroorganisms2076-26072025-01-011317110.3390/microorganisms13010071Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary StudyLiliana Gabrielli0Matteo Pavoni1Francesca Monari2Federico Baiesi Pillastrini3Maria Paola Bonasoni4Chiara Locatelli5Maria Bisulli6Alessandra Vancini7Ilaria Cataneo8Margherita Ortalli9Giulia Piccirilli10Alessia Cantiani11Simone Ambretti12Fabio Facchinetti13Tiziana Lazzarotto14Microbiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyMicrobiology, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyUnit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio-Emilia, 41124 Modena, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyPathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio-Emilia, ItalyNeonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyObstetric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyNeonatal Intensive Care Unit, Maggiore Hospital, 40133 Bologna, ItalyUnit of Obstetrics, Maggiore “C.A. Pizzardi” Hospital, AUSL, 40133 Bologna, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyMicrobiology, Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyUnit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio-Emilia, 41124 Modena, ItalyMicrobiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyBackground: Although several conditions and specific risk factors have been associated with stillbirth (SB), in most of the cases it is difficult to identify the definitive etiopathology and cause of death. Specifically, the role of infections in SB is still debated. Our aim was to study maternal, placental, and fetal tissues in cases of SB in order to define the causative link between infections and fetal death, through a multidisciplinary clinical audit. Methods: Between 2014 and 2022, microbiological investigations on maternal, placental and fetal samples of SB cases were performed according to a standardized protocol including serology, cultures, and molecular biology. Autopsies and placental examination were mandatory in all SB cases. Results: A total of 182 cases of SB were investigated. Bacteria were detected in 22.2% of vaginal swabs, 65% of placental biopsies, 29% of fetal blood, and 14.1% of oropharyngeal swabs. Vaginal and oropharyngeal swabs were positive for urogenital mycoplasmas in 25.2% and 8.6%, respectively. Positive results of microbiological investigations, in association with histological features suggestive of infection, were observed in six cases, indicating that fetal death was likely related to a bacterial infection. In one case, a high SARS-CoV-2 load was found in the placenta of a SB due to placental abruption. Conclusions: Infections were likely associated with fetal death in 3.8% of cases. Thus, in developed countries, an infection, defined when positive microbiological findings are associated with histological evidence of organ damage, is a minor contributory factor in SB.https://www.mdpi.com/2076-2607/13/1/71stillbirthinfectionmultidisciplinary auditchorioamnionitishistology |
| spellingShingle | Liliana Gabrielli Matteo Pavoni Francesca Monari Federico Baiesi Pillastrini Maria Paola Bonasoni Chiara Locatelli Maria Bisulli Alessandra Vancini Ilaria Cataneo Margherita Ortalli Giulia Piccirilli Alessia Cantiani Simone Ambretti Fabio Facchinetti Tiziana Lazzarotto Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study Microorganisms stillbirth infection multidisciplinary audit chorioamnionitis histology |
| title | Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study |
| title_full | Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study |
| title_fullStr | Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study |
| title_full_unstemmed | Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study |
| title_short | Infection-Related Stillbirths: A Detailed Examination of a Nine-Year Multidisciplinary Study |
| title_sort | infection related stillbirths a detailed examination of a nine year multidisciplinary study |
| topic | stillbirth infection multidisciplinary audit chorioamnionitis histology |
| url | https://www.mdpi.com/2076-2607/13/1/71 |
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