Role of Waddlia chondrophila placental infection in miscarriage

Abstract

Waddlia chondrophila is an intracellular bacterium suspected to cause human and bovine abortion. We confirmed an association between antibodies against W. chondrophila and human miscarriage and identified this organism in placenta or genital tract of women who had had miscarriages. These results suggest a possible role of W. chondrophila infection in miscarriage.

Keywords: Chlamydia-like bacteria; Waddlia chondrophila; adverse pregnancy outcome; bacteria; genital tract infection; human placenta; intracellular bacteria; miscarriage.

Figure 1

Histopathologic analysis of placentas from women tested for infection with Waddlia chondrophila. A) Patient 140, chronic endometritis with various inflammatory cells in the deciduas, including plasmocytes (arrows) (original magnification x600). B, Patient 183, polymorphonuclear cells (PMN) in a an endometrial gland (original magnification x400). C) Patient 305, chorioamnionitis with PMN extending from the chorion to the amnios (original magnification x200). D) Patient 535, PMN in the subchorial fibrin near the gestational sac (original magnification x400). Hematoxylin and eosin stain. Immunohistochemical analysis showing W. chondrophila in placental tissue. A rabbit polyclonal antibody directed against W. chondrophila was used at a dilution of 1:12,000. Detection was performed by using the ChemMate Kit (Dako, Glostrup, Denmark). Negative controls contained antibody diluent instead of primary antibody. Negative and positive control pellets were included as described (10). All highly positive cells were found in epithelium of endometrial glands. E) Patient 535 (miscarriage) (original magnification x400). F) Patient 535 (original magnification x600) G) Patient 523 (miscarriage) (original magnification x600). H) Patient 250 (control) (original magnification x600). 3-amino-9-ethylcarbazole/peroxidase stain and hematoxylin counterstain.

Figure 2

Decision tree for samples from placentas, which were used to screen for infection with Waddlia chondrophila. Of 386 women, a total of 5 had a confirmed infection, which was defined as a minimum of 2 independent positive W. chondrophila–-specific test results, and 31 had evidence of acute current W. chondrophila infection. IHC, immunohistochemical analysis.