Intrauterine death and infections during pregnancy.

OBJECTIVE

To elucidate whether microbial infections are involved in the etiology of intrauterine death.

METHODS

One hundred four cases of stillbirth of unknown etiology and 96 age- and parity-matched referents with live births were analyzed with respect to microbial infection by cultures from the placenta, endocervix and internal organs of the fetuses, external sites of the babies and fetuses, and by serology for bacteria, viruses and Toxoplasma gondii.

RESULTS

In 17 cases in whom no other infectious agent was diagnosed, Escherichia coli was isolated from the placenta and one or more internal fetal organs. Tests for Treponema pallidum and Toxoplasma gondii were more frequently positive in cases than in referents (O.R. 8.3 and 3.9, respectively). There was no increased risk for intrauterine death in women with human immunodeficiency virus, cytomegalovirus, herpes simplex virus or rubella virus.

CONCLUSIONS

Our findings indicate that infections remain an important cause of intrauterine death in Zimbabwe.