Placental Bacteria Found in Over 40% of Preterm Births at Ugandan Hospital

More than four in ten women who delivered preterm at a regional referral hospital in Uganda had positive aerobic bacterial cultures from placental basal plate tissue, according to a cross-sectional study conducted at Mubende Regional Referral Hospital between 15 May and 15 September 2025.

Researchers collected placental basal plate specimens aseptically immediately after delivery and processed them for aerobic bacterial culture. Positive cultures were identified in 159 women, giving a prevalence of 41.5% (95% CI: 36.5–46.6).

Sociodemographic, obstetric and clinical information was gathered through interviewer-administered questionnaires and medical record review. Associations with culture positivity were examined using multivariable logistic regression and reported as adjusted odds ratios with 95% confidence intervals, with statistical significance set at p < 0.05.

Several maternal factors were strongly associated with a positive culture. Fever showed the largest association (aOR = 11.32, 95% CI: 4.89–26.19), followed by abdominal pain or uterine tenderness (aOR = 9.13, 95% CI: 4.37–19.08). Membrane rupture lasting more than 24 hours (aOR = 5.93, 95% CI: 2.08–16.89) and no formal education (aOR = 6.97, 95% CI: 1.50–32.46) were also linked to culture positivity.

Other associated factors included HIV infection (aOR = 4.23, 95% CI: 1.21–14.74), urinary tract infection during pregnancy (aOR = 4.20, 95% CI: 2.13–8.27), foul-smelling vaginal discharge (aOR = 3.22, 95% CI: 1.48–6.97) and traditional herb use (aOR = 2.19, 95% CI: 1.16–4.13). Earlier gestational age, prolonged labour and primary education were also associated with culture positivity.

The authors note that aerobic bacterial culture positivity in placental basal plate tissue and its associated maternal factors had previously been poorly described in Uganda, making this one of the first estimates of its kind for this population.

Importantly, the researchers caution that culture positivity alone cannot distinguish invasive infection from colonization or contamination. Because the design was cross-sectional, the findings do not establish temporal or causal relationships, and the authors call for prospective studies to clarify these links.

Positive aerobic placental basal plate cultures were common in this population, and the authors state that the findings support improved recognition and management of maternal infection during antenatal and intrapartum care.

Subject of Research: Prevalence and maternal factors associated with aerobic bacterial culture positivity in placental basal plate tissue among women with spontaneous preterm births in Uganda

Article Title: Bacterial culture positivity in placental basal plate tissue and associated factors among women with spontaneous preterm births at Mubende Regional Referral Hospital, Uganda: A cross-sectional study

Article References: Kasiita, S., Ishimwe, M. P. S., Kasujja, M., Nteziyaremye, T., Liban, S., Racheal, B., Kakande, R., Bwire, I., Neel, G. R., Namutebi, S., Abdallah, Z., & Hakizimana, T. (2026). Bacterial culture positivity in placental basal plate tissue and associated factors among women with spontaneous preterm births at Mubende Regional Referral Hospital, Uganda: A cross-sectional study. PLOS Global Public Health, 6(10), e0007002. https://doi.org/10.1371/journal.pgph.0007002

Image Credits: AI Generated

DOI: 10.1371/journal.pgph.0007002

Keywords: placental basal plate, bacterial culture, preterm birth, Uganda, cross-sectional study, maternal infection, chorioamnionitis, aerobic bacteria, Mubende Regional Referral Hospital, public health, Bacterial, culture