Bacterial vaginosis, intrauterine infection, neonatal outcome-a review of current knowledg

There have been major advances in the care of preterm infants. Reduction in mortality among very low birth weight infants has lead to a rise in the number of survivors with severe handicaps. The understanding of preterm labour has evolved, leading to a significant change in the management of preterm labour. Despite this, infection still remains a major cause of preterm delivery. In our review we present the recent knowledge concerning intrauterine infection, preterm delivery and its implications for the very low birth weight infant. Amniotic cavity infection are most frequently related to microbial invasion, which leads to cytokine production and release of prostaglandins, followed by preterm delivery. Additionally bacteria present in the amnion may be swallowed by the foetus leading to a foetal inflammation syndrome (FIRS), characterized by bacteraemia and multi-organ failure. Intrauterine microbial invasion of the foetus has important prognostic implications for the preterm newborn. Based on our review we postulate that neonatologists should always request pathologic examination of the placenta after each preterm delivery at less than 32 weeks of gestation.