PT - JOURNAL ARTICLE AU - Carole Frenzer AU - Dianne Egli-Gany AU - Lisa M Vallely AU - Andrew J Vallely AU - Nicola Low TI - Adverse pregnancy and perinatal outcomes associated with <em>Mycoplasma genitalium:</em> systematic review and meta-analysis AID - 10.1136/sextrans-2021-055352 DP - 2022 May 01 TA - Sexually Transmitted Infections PG - 222--227 VI - 98 IP - 3 4099 - http://sti.bmj.com/content/98/3/222.short 4100 - http://sti.bmj.com/content/98/3/222.full SO - Sex Transm Infect2022 May 01; 98 AB - Objective To examine associations between Mycoplasma genitalium infection during pregnancy and adverse outcomes.Methods We did a systematic review of observational studies. We searched Medline, EMBASE, the Cochrane Library and CINAHL up to 11 August 2021. Studies were included if they compared preterm birth, spontaneous abortion, premature rupture of membranes, low birth weight or perinatal death between women with and without M. genitalium. Two reviewers independently assessed articles for inclusion and extracted data. We used random-effects meta-analysis to estimate summary ORs and adjusted ORs, with 95% CIs, where appropriate. Risk of bias was assessed using established checklists.Results We identified 116 records and included 10 studies. Women with M. genitalium were more likely to experience preterm birth in univariable analyses (summary unadjusted OR 1.91, 95% CI 1.29 to 2.81, I2=0%, 7 studies). The combined adjusted OR was 2.34 (95% CI 1.17 to 4.71, I2=0%, 2 studies). For spontaneous abortion, the summary unadjusted OR was 1.00 (95% CI 0.53 to 1.89, I2=0%, 6 studies). The adjusted OR in one case–control study was 0.9 (95% CI 0.2 to 3.8). Unadjusted ORs for premature rupture of membranes were 7.62 (95% CI 0.40 to 145.86, 1 study) and for low birth weight 1.07 (95% CI 0.02 to 10.39, 1 study). For perinatal death, the unadjusted OR was 1.07 (95% CI 0.49 to 2.36) in one case–control and 38.42 (95% CI 1.45 to 1021.43) in one cohort study. These two ORs were not combined, owing to heterogeneity. The greatest risk of bias was the failure in most studies to control for confounding.Conclusion M. genitalium might be associated with an increased risk of preterm birth. Further prospective studies, with adequate control for confounding, are needed to understand the role of M. genitalium in adverse pregnancy outcomes. There is insufficient evidence to indicate routine testing and treatment of asymptomatic M. genitalium in pregnancy.PROSPERO registration number CRD42016050962.All data are available in the manuscript or the online supplemental materials.