Ureaplasma and Mycoplasma Screening for Pregnant Individuals Who Are at High Risk for Preterm Birth

Abstract

Objective This study aimed to examine gestational age at delivery according to Ureaplasma/Mycoplasma cervical culture results and whether pregnant individuals received antibiotics.

Study Design A retrospective cohort study at a single academic institution where all pregnant individuals with risk factors for preterm birth including those with a history of preterm birth, recurrent pregnancy loss, or pregnancy requiring cervical cerclage were included. We plotted Kaplan–Meier curves to investigate the association between the gestational age at delivery and Ureaplasma culture results (negative; positive and treated; or positive but did not receive the treatment). A Cox proportional regression model was used to calculate hazard ratio (HR) with 95% confidence intervals (95% CI), controlling for confounders. The main outcome was age at delivery. Analyses were repeated for Mycoplasma culture.

Results Of 607 individuals, 258 (42.5%) had a negative Ureaplasma culture, 308 (50.7%) had a positive Ureaplasma culture and received treatment, and 41 (6.8%) had a positive Ureaplasma culture and did not receive treatment. Compared with those who had a positive Ureaplasma culture but did not receive treatment, those who had a negative Ureaplasma culture did not have a decreased risk (HR: 1.03; 95% CI: 0.74–1.44). Compared with those who had a positive Ureaplasma culture but did not receive treatment, those who had a positive Ureaplasma culture and received treatment did not have a decreased risk (HR: 0.91; 95% CI: 0.66–1.27). The treatment failure rate of Ureaplasma after treatment was 78.6% (95% CI: 72.8–83.7%). Overall, the findings of Mycoplasma were similar.

Conclusion Routine ureaplasma/mycoplasma cervical culture is not recommended for pregnant individuals who are at high risk for preterm birth.

Key Points

• Ureaplasma/mycoplasma species are isolated in patients with preterm birth.

• High ureaplasma/mycoplasma recurrence rate despite treatment with antibiotics.

• Treatment of patient and partner did not improve gestational age at delivery.

Keywords

antibiotics - mycoplasma - preterm birth - quality initiative - recurrence - ureaplasma

Ethical Approval

This study was approved by the Eastern Virginia Medical School Institutional Review Board (IRB approval no.: 21-02-XX-0032) On April 30, 2021.

Publikationsverlauf

Eingereicht: 07. Januar 2023

Angenommen: 30. Juni 2023

Artikel online veröffentlicht:
29. Juli 2023

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