Genital mycoplasma infection and spontaneous preterm birth outcome: a prospective cohort study

Objective To assess the risk of spontaneous preterm birth (sPTB) associated with genital mycoplasma infection in asymptomatic women. Design Prospective cohort. Setting Public and private health services in Ribeirao Preto, SP, Brazil. Population A cohort of 1349 asymptomatic women with a singleton pregnancy at 20-25 weeks of gestation. Methods Participants completed a sociodemographic and clinical history questionnaire during the prenatal visit and provided cervicovaginal samples for the evaluation of Mycoplasma hominis (Mh), Ureaplasma spp. and bacterial vaginosis (BV). For gestational outcome, information about the delivery was assessed and sPTB was defined as a birth that occurred before 37 weeks of gestation. The association between variables and the risk of sPTB was evaluated using logistic regression analysis to estimate the odds ratios (ORs). Main outcome measures Genital mycoplasma infection and prematurity. Results The prevalence of sPTB and genital mycoplasma was 6.8 and 18%, respectively. The infection was not a risk factor for sPTB (aOR 0.66, 95% CI 0.32-1.35), even when Mh and Ureaplasma spp. were found together (P = 0.83). Pregnant women with genital mycoplasma infections had greater BV (P < 0.0001), but this vaginal microbiota condition was not associated with sPTB (P = 0.35). Regarding the risk factors associated with sPTB, a previous history of sPTB (aOR 12.06, 95% CI 6.21-23.43) and a cervical length of <= 2.5 cm (aOR 3.97, 95% CI 1.67-9.47) were significant. Conclusions Genital mycoplasma infection was not a risk factor for sPTB, even in the presence of other abnormal vaginal microbiota. Tweetable abstract Genital mycoplasma infection was not a risk for sPTB, even when associated with bacterial vaginosis (BV).