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Genital mycoplasma infection and spontaneous preterm birth outcome: a prospective cohort study
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  • Giulia Cunha,
  • Larissa Bastos,
  • Stella Freitas,
  • Ricardo Cavalli,
  • Silvana Quintana
Giulia Cunha
Universidade de São Paulo Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
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Larissa Bastos
Universidade de São Paulo Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
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Stella Freitas
Universidade de São Paulo Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
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Ricardo Cavalli
Universidade de São Paulo Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
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Silvana Quintana
Universidade de São Paulo Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto
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Abstract

Objective To determine the prevalence of genital mycoplasma infection and the risk of spontaneous preterm birth (sPTB) in asymptomatic pregnant women. Design Prospective cohort. Setting Public and private health services in Ribeirão Preto-SP, Brazil. Population 1.349 asymptomatic women with a singleton pregnancy at 20-25 weeks of gestation (WG) recruited between 2010 and 2011. Methods Baseline data was assessed using a questionnaire, in addition to cervicovaginal fluid and blood samples, to analyze lower reproductive tract infections (RTIs) and immune mediators, respectively. The association between variables and the risk of sPTB was evaluated using logistic regression analysis to estimate the odds ratios (ORs). Main outcome measures Genital mycoplasma infection and prematurity. Results The prevalence of the sPTB and genital mycoplasma was 6.8% and 18%, respectively. The infection was not a risk factor for sPTB (aOR 0.66; 95% CI 0.32-1.35), even when associated with bacterial vaginosis (BV). However, it was associated with a low socioeconomic status (p=0.0470), cigarette use (p=0.0009), number of sexual partners (p=0.0019), and BV (p<.0001). Regarding the risk factors associated with sPTB, previous history of PTB (aOR 12.06; 95% CI 6.21-23.43) and a cervical length ≤ 2.5 cm (aOR 3.97; 95% CI 1.67-9.47) were significant. Conclusions The risk of sPTB was independently associated with the history of PTB and the cervical length but not with the genital mycoplasma infection. Funding: This work was founded by CNPq, FAPESP and CAPES. Keywords: Preterm birth, pregnancy, genital mycoplasma, bacterial vaginosis, risk factor

Peer review status:ACCEPTED

29 Jun 2021Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
29 Jun 2021Submission Checks Completed
29 Jun 2021Assigned to Editor
29 Jun 2021Reviewer(s) Assigned
07 Jul 2021Review(s) Completed, Editorial Evaluation Pending
04 Aug 2021Editorial Decision: Revise Major
08 Sep 20211st Revision Received
09 Sep 2021Review(s) Completed, Editorial Evaluation Pending
09 Sep 2021Submission Checks Completed
09 Sep 2021Assigned to Editor
21 Sep 2021Editorial Decision: Accept