Ukrainian Journal Health of Woman. 2026. 1(182): 64-71. doi: 10.15574/HW.2026.1(182).6471
Siracli U. M.
Azerbaijan Medical University, Baku

For citation: Siracli UM. (2026). Spectrum of urogenital infections in pregnant women with fetal growth restriction. Ukrainian Journal Health of Woman. 1(182): 64-71. doi: 10.15574/HW.2026.1(182).6471
Article received: Oct 10, 2025. Accepted for publication: Jan 28, 2026.

Urogenital infections during pregnancy may contribute to placental dysfunction, fetal growth restriction (FGR), and adverse perinatal outcomes, though their impact on maternal-placental-fetal circulation is not well understood.
Aim – to evaluate the prevalence of urogenital infections in pregnant women with FGR and their impact on Doppler parameters, cardiotocography (CTG), and perinatal outcomes.
Materials and methods. A prospective cohort study was conducted from 2023 to 2025, including 90 pregnant women: 45 with FGR and 45 with uncomplicated pregnancies. Assessments included laboratory testing for Ureaplasma spp., Mycoplasma spp., Chlamydia trachomatis, and human papillomavirus; Doppler ultrasound of uterine, umbilical, and fetal middle cerebral arteries; cerebroplacental ratio (CPR); CTG; and perinatal outcomes. Statistical analysis used t-tests, χ² tests, and odds ratios (OR) with 95% confidence intervals; p<0.05 was considered significant.
Results. Urogenital infections were more common in the FGR group, but differences were not statistically significant. Monoinfections predominated (28.9%). Infected women showed higher uterine (1.34±0.27 vs 1.11±0.22) and umbilical artery pulsatility indices (0.98±0.17 vs 0.81±0.15), lower CPR (1.49±0.36 vs 1.96±0.41), and more frequent CTG abnormalities (33.3% vs 8.7%). Perinatal outcomes were worse: lower birth weight (2450±310 g vs 3220±280 g), higher preterm birth (20% vs 6.7%), and low birth weight (<2500 g, 24.4% vs 4.4%).
Conclusions. Urogenital infections may cause placental dysfunction and fetal hypoxia. Infected women showed Doppler and CTG changes, highlighting the need for early detection and treatment to improve perinatal outcomes.
The study was performed in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the patients was obtained for the research.
The authors declare no conflict of interest.
Keywords: urogenital infections, fetal growth restriction, Doppler ultrasound, cerebroplacental ratio, maternal-placental-fetal circulation, pregnancy complications.

REFERENCES

1. Bahrami R, Schwartz DA, Karimi-Zarchi M et al. (2021). Meta-analysis of intrauterine growth restriction and pregnancy complications. Turk J Obstet Gynecol. 18(3): 236-244. https://doi.org/10.4274/tjod.galenos.2021.74829; PMid:34580931 PMCid:PMC8480208

2. Chen Y, Huang M, Shi D, Lin J, Guo J, Yang Y et al. (2025). Correlation between fetal-placental Doppler indices and maternal cardiac function in pregnancies complicated by fetal growth restriction. BMC Pregnancy Childbirth. 25: 740. https://doi.org/10.1186/s12884-025-07848-x; PMid:40634840 PMCid:PMC12243227

3. Cox C, Saxena N, Watt AP, Gannon C, McKenna JP, Fairley DJ et al. (2016). The common vaginal commensal bacterium Ureaplasma parvum is associated with chorioamnionitis in extreme preterm labor. J Matern Fetal Neonatal Med. 29(22): 3646-3651. https://doi.org/10.3109/14767058.2016.1140734; PMid:26795404

4. Di Martino DD, Avagliano L, Ferrazzi E, Fusè F, Sterpi V, Parasiliti M et al. (2022, Aug 10). Hypertensive Disorders of Pregnancy and Fetal Growth Restriction: Clinical Characteristics and Placental Lesions and Possible Preventive Nutritional Targets. Nutrients. 14(16): 3276. https://doi.org/10.3390/nu14163276; PMid:36014782 PMCid:PMC9414322

5. Ignatko IV, Bogomazova IM, Kardanova MA. (2023). Current views on the diagnosis and prognosis of fetal growth restriction: a literature review. J Obstet Womens Dis. 72(3): 65-76. https://doi.org/10.17816/JOWD344442

6. Jonduo ME, Vallely LM, Wand H, Sweeney EL, Egli-Gany D, Kaldor J et al. (2022). Adverse pregnancy and birth outcomes associated with Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum: a systematic review and meta-analysis. BMJ Open. 12(8): e062990. https://doi.org/10.1136/bmjopen-2022-062990; PMid:36028274 PMCid:PMC9422885

7. Khalafli KN, Taghieva FS, Ragimov JA et al. (2024). Main tendencies in the dynamics of the population of Azerbaijan. Azerbaijan Med J. (2): 116-122.

8. Khalafli K, Taghieva F, Ragimov D, Rustamova L et al. (2025). Regional characteristics of fertility dynamics in Azerbaijan. Azerbaijan Med J. (1): 122-126.

9. Low N. (2020). Chlamydia trachomatis and reproductive health: what can we learn from systematic reviews of observational studies? Sex Transm Infect. 96(5): 315-317. https://doi.org/10.1136/sextrans-2019-054279; PMid:31988220

10. Peretz A, Tameri O, Azrad M et al. (2020). Mycoplasma and Ureaplasma carriage in pregnant women: the prevalence of transmission from mother to newborn. BMC Pregnancy Childbirth. 20: 456. https://doi.org/10.1186/s12884-020-03147-9; PMid:32781998 PMCid:PMC7422580

11. Plummer EL, Vodstrcil LA, Bodiyabadu K, Murray GL, Doyle M, Latimer RL et al. (2021). Are Mycoplasma hominis, Ureaplasma urealyticum and Ureaplasma parvum associated with specific genital symptoms and clinical signs in nonpregnant women? Clin Infect Dis. 73(4): 659-668. https://doi.org/10.1093/cid/ciab061; PMid:33502501

12. Rauh M, Werle F, Schmidt B, Litzka C, Solano ME, Köninger A. (2024). Prevalence of genital Mycoplasma in pregnancies with shortened cervix. Arch Gynecol Obstet. 310(2): 971-979. https://doi.org/10.1007/s00404-023-07252-w; PMid:37874353 PMCid:PMC11258085

13. Xu YP, Hu JM, Huang YQ, Shi LP. (2022). Maternal Ureaplasma exposure during pregnancy and the risk of preterm birth and bronchopulmonary dysplasia: a meta-analysis. Arch Gynecol Obstet. 306(6): 1863-1872. https://doi.org/10.1007/s00404-022-06491-7; PMid:35277749