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, exteral 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. Conlusions: Our findings indicate that infections remain an important case of intrauterine death in Zimbabwe. © 1995.