Urogenital mycoplasmas are a frequent cause of congenital fetal infection. Over 20% of
neonates born between 23 and 32 weeks of gestation have positive umbilical blood
cultures for Ureaplasma urealyticum and M. hominis. Mycoplasma infection is an 
important  cause for lung diseases of the premature neonate, especially those with
very low birtweight. These neonates get infected either in utero or during passage
through the birth canal.

Respiratory distress syndrome (RDS)

Evidence that Ureaplasma cause RDS includes isolation of the bacteria in pure culture
from the nasopharynx and/or tracheal lavage of the premature and low-birth neonate;
supported by radiographic changes in the culture-positive infants 

Bronchopulmonary dysplasia

Bronchopulmonary dysplasia (BPD) is a chronic lung disease  which might develop
following RDS. Although the etiology of BPD is multifactorial human studies indicate that Ureaplasma and mycoplasma infection promotes an inflammatory cascade in the lung
and may impair alveolar development directly or in conjunction with oxidant and
ventilator-induced lung injury. It has also been shown that presence of mycoplasmas
in the tracheal aspirates is associated with an increased likelihood of developing
severe BPD.

Bacteremia

It has been reported that approximately 26% of neonates who were culture-positive
for Ureaplasma spp. in the lower respiratory tract were bacteremic with these
organisms. Furthermore, ureaplasmal bacteremia may accompany severe neonatal
pneumonia and meningitis.

Meningitis and other systemic conditions

Mycoplasmal meningitis appears to be common in very low birth weight infants, and
may occur in those born at term. Several studies have confirmed that Ureaplasma
and M. hominis are the etiologic agents of CSF infections in neonates. Ureaplasma
has been deteced in serum and/or CSF of up to 23% of pre-terms infants. 

A number of other infectious conditions have been ascribed to the ureaplasmas
including hydrops fetalis and brain abscesses.




Key take-home message

Given the frequency of these infections and their association with neonatal complications, it seems important to to test and treat women likely to deliver
an early gestational age infant. This might significant reduce subsequent
neonatal morbidity and mortality.