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Term Stillbirth Caused by Oral Fusobacterium nucleatum

Han, Yiping W. PhD; Fardini, Yann PhD; Chen, Casey DDS, PhD; Iacampo, Karla G. MD; Peraino, Victoria A.; Shamonki, Jaime M. MD; Redline, Raymond W. MD

doi: 10.1097/AOG.0b013e3181cb9955
Case Reports

BACKGROUND: Intrauterine infection is a recognized cause of adverse pregnancy outcome, but the source of infection is often undetermined. We report a case of stillbirth caused by Fusobacterium nucleatum that originated in the mother's mouth.

CASE: A woman with pregnancy-associated gingivitis experienced an upper respiratory tract infection at term, followed by stillbirth a few days later. F. nucleatum was isolated from the placenta and the fetus. Examination of different microbial floras from the mother identified the same clone in her subgingival plaque but not in the supragingival plaque, vagina, or rectum.

CONCLUSION: F. nucleatum may have translocated from the mother's mouth to the uterus when the immune system was weakened during the respiratory infection. This case sheds light on patient management for those with pregnancy-associated gingivitis.

Fusobacterium nucleatum translocates from the mother's mouth to her uterus after an upper respiratory infection, resulting in term stillbirth.

From the Department of Periodontics, School of Dental Medicine, Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio; the Division of Primary Oral Health Care, School of Dentistry, University of Southern California, Los Angeles, Los Angeles, California; and the Departments of Obstetrics and Gynecology and Pathology, Saint John's Health Center, Santa Monica, California.

Supported in part by National Institute of Dental and Craniofacial Research grants RO1 DE 14924, KO2 DE 16102, and R21 DE171650 (Y.W.H.).

The authors thank Dr. Floyd Dewhirst for consultation on the use of the Human Oral Microbiome Database.

Presented at the Gordon Research Conference on Periodontal Diseases, August 2–7, 2009, New London, New Hampshire.

Corresponding author: Yiping W. Han, PhD, Department of Periodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106-4905; e-mail: yiping.han@case.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2010 The American College of Obstetricians and Gynecologists