Genital mycoplasma infection and spontaneous preterm birth outcome: a
prospective cohort study
Abstract
Objective To determine the prevalence of genital mycoplasma infection
and the risk of spontaneous preterm birth (sPTB) in asymptomatic
pregnant women. Design Prospective cohort. Setting Public and private
health services in Ribeirão Preto-SP, Brazil. Population 1.349
asymptomatic women with a singleton pregnancy at 20-25 weeks of
gestation (WG) recruited between 2010 and 2011. Methods Baseline data
was assessed using a questionnaire, in addition to cervicovaginal fluid
and blood samples, to analyze lower reproductive tract infections (RTIs)
and immune mediators, respectively. 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 the 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
associated with bacterial vaginosis (BV). However, it was associated
with a low socioeconomic status (p=0.0470), cigarette use (p=0.0009),
number of sexual partners (p=0.0019), and BV (p<.0001).
Regarding the risk factors associated with sPTB, previous history of PTB
(aOR 12.06; 95% CI 6.21-23.43) and a cervical length ≤ 2.5 cm (aOR
3.97; 95% CI 1.67-9.47) were significant. Conclusions The risk of sPTB
was independently associated with the history of PTB and the cervical
length but not with the genital mycoplasma infection. Funding: This work
was founded by CNPq, FAPESP and CAPES. Keywords: Preterm birth,
pregnancy, genital mycoplasma, bacterial vaginosis, risk factor