The Effect of Macrolide Therapy on Bronchopulmonary Dysplasia in Ureaplasma-Positive Very Low Birth Weight Infants

Objective: Ureaplasma has been demonstrated the cause of short and long-term morbidities of preterm infants, especially such as bronchopulmonary dysplasia (BPD). This study aims to evaluate the influence of Ureaplasma on neonatal morbidities and the effect of macrolide treatment in very low birth weight (VLBW) infants. Methods: We performed a retrospective review of clinical records of VLBW infants born between 2015 and 2016. Their endotracheal aspirate and gastric juice were obtained immediately after birth and tested for Ureaplasma. Therapeutic macrolides were administered according to the clinical judgment, not routinely, in Ureaplasma-positive infants. Neonatal morbidities were compared using individual matching analysis between Ureaplasma-positive and negative groups, and with macrolides administration. Results: A total of 144 infants with the mean (±standard deviation) gestational age of 28+3 (±3+3) weeks and birth weight of 1,051.9 (±290.0) g were included, and 30 (20.8%) were Ureaplasma-positive. Ureaplasma-positive group was associated with higher incidence of respiratory distress syndrome (RDS, P=0.039) and severe neurologic injury (SNI; intraventricular hemorrhage ≥grade 3 or periventricular leukomalacia, P=0.013). However, Ureaplasma-positive group was not associated with the risk of BPD (P=0.706). In the subgroup analysis for Ureaplasma-positive infants, there was no difference in the incidence of morbidities according to the macrolides administration. Conclusion: Although Ureaplasma has no independent role in the development of BPD, Ureaplasma- positive VLBW infants were more likely to have RDS and SNI. The macrolides administered in Ureaplasma-positive was not effective to reduce neonatal morbidities.