Prevalence of genital Mycoplasma in pregnancies with shortened cervix,Archives of Gynecology and Obstetrics

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Prevalence of genital Mycoplasma in pregnancies with shortened cervix
Archives of Gynecology and Obstetrics ( IF 2.1 ) Pub Date : 2023-10-24 , DOI: 10.1007/s00404-023-07252-w
Maximilian Rauh ₁ , Franziska Werle ₁ , Börge Schmidt ₂ , Christian Litzka ₁ , Maria Emilia Solano ₃ , Angela Köninger ₁

Affiliation

Objective

To determine whether colonisation with genital Mycoplasma species (spp.) in patients presenting with a shortened cervix before 34th week of pregnancy is associated with preterm birth.

Methods

The collection of this retrospective study consisted of 100 pregnant women who presented to a German Tertiary Perinatal Center between 2017 and 2020 due to a shortened cervix defined as a cervical length of 25 mm or shorter measured by transvaginal ultrasound before 34 weeks of gestation. At the time of admission, gestational age ranged from 18 + 4 to 33 + 3 weeks (+ days) of pregnancy. All patients underwent urine polymerase chain reaction (PCR) for genital Mycoplasma [Ureaplasma (U.) urealyticum, U. parvum, M. hominis or M. genitalium]. Patients who were tested positive underwent a therapy with macrolides (azithromycin or clarithromycin).

Results

37% of the patients were positive for Ureaplasma spp., whereas 5% (5 patients) were Mycoplasma spp.-positive. All the latter were simultaneously colonised with Ureaplasma spp. Ureaplasma-positive patients were significantly younger than those who were tested negative. Median maternal age at examination was 30 years (a) versus 31a (p = 0.04). There was no difference between Ureaplasma-positive and -negative patients regarding median maternal body mass index (BMI) (kg/m²) (23.4 versus 22.3, p = 0.41), cervical length at admission (mm) (15 versus 17, p = 0.17), gestational age at examination (days, d) (198 versus 197, p = 0.97) or gestational age at birth (d) (250 versus 257, p = 0.33), respectively. Comparing U. parvum-positive and U. urealyticum-positive patients, there was some weak indication that U. parvum-positive patients may get a shortening of the cervix earlier in pregnancy, as the median gestational age at examination was 196d versus 215d (p = 0.06). Regarding Mycoplasma-positive and -negative patients, there was no difference in all examined parameters.

Conclusions

Overall, one-third of all women in our study with a shortened cervix before 34th week of pregnancy were colonised with genital Mycoplasma spp. We were able to show that pregnant women, who were treated with antibiotics when tested positive for genital Mycoplasma, gave birth at the same gestational age as patients with a shortened cervix without detected Mycoplasma. This raises the question of whether routine testing and early antibiotic treatment should be established in prenatal care.

中文翻译：

宫颈缩短妊娠中生殖器支原体的患病率

目的

确定妊娠 34 周前宫颈缩短患者的生殖器支原体 （spp.）定植是否与早产有关。

方法

这项回顾性研究的集合包括 100 名孕妇，她们在 2017 年至 2020 年间因宫颈缩短而到德国三级围产中心就诊，定义为在妊娠 34 周前通过经阴道超声测量宫颈长度为 25 毫米或更短。入院时，胎龄从 18 + 4 到 33 + 3 周（+ 天）不等。所有患者均接受了生殖器支原体 [解脲支原体 （U.）urealyticum， U.parvum， M.hominis 或 M.生殖器]。检测呈阳性的患者接受了大环内酯类药物（阿奇霉素或克拉霉素）治疗。

结果

37% 的患者解脲支原体属阳性，而 5% （5 名患者）支原体属阳性。所有这些 Ureaplasma 阳性患者同时与 Ureaplasma spp 定植。解脲支原体阳性患者明显年轻于检测阴性的患者。检查时孕妇的中位年龄为 30 岁（a）和 31a （p = 0.04）。解脲支原体阳性和阴性患者在中位母体质量指数（BMI）（kg/m²）（23.4 vs 22.3，p = 0.41）、入院宫颈长度（mm）（15 vs 17，p = 0.17）、检查胎龄（天，d）（198 对 197，p = 0.97）或出生胎龄（d）（250 对 257，p = 0.33）方面没有差异，分别。比较 U.parvum 阳性和 U.解脲管阳性患者，有一些微弱的迹象表明 U.Parvum 阳性患者可能在妊娠早期宫颈缩短，因为检查时的中位胎龄为 196 天对 215 天（p = 0.06）。关于支原体阳性和阴性患者，所有检查参数均无差异。