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Is genital colonization with Mycoplasma hominis or Ureaplasma urealyticum associated with prematurity/low birth
1Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut.
Abstract:
Mycoplasma species have been implicated in the pathogenesis of prematurity, intrauterine growth retardation, low birth weight (LBW), and preterm premature rupture of membranes. The purpose of this study was to review the available literature to determine whether there is an association between genital colonization with Mycoplasma hominis or Ureaplasma urealyticum and prematurity/LBW. Twelve studies were reviewed: nine cohort studies, two case-control studies, and one randomized clinical trial of treatment. The overall isolation rate of M hominis from the genital tract was 27.2%, whereas that of U urealyticum was 70.4% (cohort studies). Results from the randomized clinical trial showed that treatment did not alter the rate of prematurity in women carrying mycoplasma species in the genital tract. None of the cohort studies supported an association between genital colonization with U urealyticum and prematurity/LBW. Similarly, no association between M hominis and prematurity/LBW could be demonstrated in seven of the eight and in six of the eight cohort studies, respectively. On the other hand, two case-control studies showed an association between U urealyticum colonization and prematurity without an association with M hominis. We conclude that the weight of the evidence does not support an association between genital colonization with mycoplasma species and prematurity/LBW.
Insights
Genital colonization with Mycoplasma hominis or Ureaplasma urealyticum is not supported by current evidence to cause prematurity or low birth weight (LBW). Further research is needed to clarify potential associations.
Area of Science:
- Obstetrics and Gynecology
- Microbiology
- Neonatology
Background:
- Mycoplasma species, including Mycoplasma hominis and Ureaplasma urealyticum, are frequently found in the female genital tract.
- These microorganisms have been suggested as potential contributors to adverse pregnancy outcomes such as prematurity and low birth weight (LBW).
Purpose of the Study:
- To systematically review existing literature and evaluate the association between genital colonization with Mycoplasma hominis or Ureaplasma urealyticum and the incidence of prematurity/LBW.
Main Methods:
- A comprehensive literature search was conducted, identifying twelve relevant studies.
- These included nine cohort studies, two case-control studies, and one randomized clinical trial investigating treatment efficacy.
- Data on isolation rates and associations with adverse pregnancy outcomes were extracted and analyzed.
Main Results:
- Overall isolation rates were high: 27.2% for Mycoplasma hominis and 70.4% for Ureaplasma urealyticum in cohort studies.
- The majority of cohort studies (seven of eight for M. hominis, all for U. urealyticum) found no significant association with prematurity/LBW.
- A randomized clinical trial indicated that treatment for mycoplasma did not reduce prematurity rates.
Conclusions:
- The current body of evidence does not support a causal link between genital mycoplasma colonization and prematurity or low birth weight.
- While some case-control studies suggested an association, the overall evidence, particularly from cohort studies, is inconclusive.
- Further investigation may be warranted to fully elucidate the role of these microorganisms in pregnancy outcomes.