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We thank M.H. F. Sullivan for his kind comments regarding our recently published paper on the detection of bacteria within human placental tissue. We strongly support the opinion that the uterus during the second trimester is not a sterile organ. Indeed, the presence of low levels of microorganisms may serve as an important early stimulus for the developing fetal immune system. However, failure of the placenta to modulate the numbers and types of microorganisms present may lead to an inflammatory process that can potentially damage the developing fetus and result in preterm birth.
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