(1110) The association of Mycoplasma genitalium and adverse perinatal outcomes in high-risk pregnant women

Mycoplasma genitalium (M. genitalium) is a known cause of sexually transmitted disease and genital tract pathology in women. Retrospective studies have linked the mycoplasmas to adverse maternal and neonatal outcomes. The primary aim of this prospective observational cohort study was to determine the association of M. genitalium with adverse perinatal outcomes in high-risk pregnant women.

Study Design:

After institutional approval, 500 pregnant patients with a history of pregnancy loss, cervical insufficiency (CI), or preterm birth (PTB) were enrolled between 07/23-12/24. Vaginal swabs were tested for M. genitalium using the FDA-cleared Aptima M. genitalium transcription-mediated amplification (TMA) assay (Hologic Inc, San Diego, CA). Patients and providers were blinded to results prior to delivery. All obstetrical, neonatal, and infection-related data were recorded. The primary outcome was a composite of adverse pregnancy outcomes including recurrent PTB, CI, or pregnancy loss. Secondary outcomes included two separate composites: one for adverse maternal outcomes (e.g., infectious morbidity) and another for adverse neonatal outcomes. Continuous variables were compared using t-tests or Wilcoxon rank-sum tests, and categorical variables with chi-square or Fisher’s exact tests. Adjusted relative risks (aRR) with 95% confidence intervals (CIs) were reported.

Results:

Of the 500 patients enrolled, 490 (98%) had complete data. Fifty-seven (11.6%) tested positive for M. genitalium. M. genitalium was significantly associated with prior PTB (p < 0.05). There was no significant difference in the composite adverse pregnancy outcome between groups (34.6% vs. 40.3%; aRR 0.80, 95% CI: 0.55–1.15) (Table 1), the composite adverse maternal outcome (7.1% vs. 14.0%; aRR 0.47, 95% CI: 0.18–1.26), or the composite neonatal outcome (45.5% vs. 42.9%; p = 0.72) (Table 2).

Conclusion:

M. genitalium was not associated with recurrent adverse pregnancy outcomes, maternal morbidity, or adverse neonatal outcomes in this high-risk pregnant cohort. These findings may help inform screening guidelines for pregnant populations.