General Obstetrics and Gynecology: Obstetrics
Midtrimester vaginal Mycoplasma genitalium in women with subsequent spontaneous preterm birth

https://doi.org/10.1067/mob.2001.115113Get rights and content

Abstract

Objective: We sought to determine the midtrimester prevalence of Mycoplasma genitalium in women who had subsequent spontaneous preterm birth. Study Design: In a prospective study of lower genital tract infections, we identified 127 women who subsequently had spontaneous preterm birth. Vaginal samples were obtained between 21 and 25 weeks’ gestation for pH, for bacterial vaginosis Gram stain, and cultures that yielded Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. M genitalium was identified by using validated polymerase chain reaction (PCR) primers, and the results were compared to pregnancy outcomes. Results: Of 124 women with spontaneous preterm births, only five (3.9%) had PCR assays positive forM genitalium. The mean ± SD delivery gestational age was similar for women with a positive PCR (34.6 ± 2.2 weeks) and a negative PCR (34.0 ± 2.7 weeks) (P =.62). None of the women with positive PCR results tested positive for any other sexually transmitted disease, whereas 36 (30%) women with negative PCR results tested positive. Conclusions: The occurrence of M genitalium in the vagina at midtrimester is infrequent in women with subsequent spontaneous preterm birth. (Am J Obstet Gynecol 2001;185:163-5.)

Section snippets

Patients

In an ongoing observational prospective study of the association between lower genital tract infections and pregnancy outcomes, 127 women were identified who had subsequent spontaneous preterm birth. Women were eligible for participation in the study if they presented for prenatal care before 26 weeks with a singleton gestation. Exclusion criteria included metronidazole use within the 2 weeks before study enrollment, any vaginal symptoms (ie, itching, malodor), active vaginal bleeding, symptoms

Results

Of 127 women with subsequent spontaneous preterm birth during the prospective trial, 124 had samples sufficient for PCR analysis. Only 5 (3.9%) women had a PCR positive for M genitalium. Demographics of the women with a positive PCR did not differ significantly from those with a negative PCR. The mean gestational age at the time of sampling was significantly earlier in women with a negative PCR compared with those with a positive PCR (22.4 weeks ± 1.3 weeks versus 24.1 weeks ± 1.8 weeks, P

Comment

In nonpregnant women, M genitalium has been linked to 5% to 20% of cases of nongonococcal urethritis and to the pathogenesis of pelvic inflammatory disease.7 In contrast, information is limited about any association of M genitalium with adverse pregnancy outcomes. Blanchard et al5 failed to detect M genitalium by either culture or PCR in the amniotic fluid of 232 women with singleton pregnancies and intact membranes who underwent cesarean delivery. However, additional information regarding

References (12)

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Reprint requests: George C. Lu, MD, Division of Maternal-Fetal Medicine, 619 S 19th St, 451 OHB, Birmingham, AL 35249-7333. E-mail: [email protected].

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