Results
Of 607 pregnant individuals. 258 (42.5%) had a negative Ureaplasma culture, 308 (50.7%) had a positive Ureaplasma culture and received treatment, and 41 (6.8%) had a positive Ureaplasma culture and did not receive treatment. (Figure 1).
Maternal demographics are presented in Table 1. There were statistical differences in distributions and proportions of maternal age, race and ethnicity, smoking, illicit drug, Trichomonas vaginalis co-infection, and reason for Ureaplasma culture. Compared to pregnant individuals who had a negative culture, those who had a positive Ureaplasma and received treatment were more likely to be younger, non-Hispanic black, co-infected with Trichomonas vaginalis, and have Ureaplasma culture indicated for a history of preterm birth (P<0.05). Compared to pregnant individuals who had a negative culture, those who had a positive Ureaplasma and did not receive treatment were more likely to be smokers (P=0.02).
Kaplan Meier curves are presented in Figure 2. There was no difference in gestational age at delivery (Log-rank P=0.40). There was no difference in median gestational age at delivery between groups (negative 37.4 [interquartile 36.0-39.0] weeks vs. positive and received treatment 37.7 [35.6-39.0] weeks vs. positive and did not receive treatment 37.3 [36.0-38.7] weeks; P =0.57). Hazard ratios are presented in Table 2. Compared to those who had a positive Ureaplasma culture but did not receive treatment, those who had a negative Ureaplasma culture did not have decreased a risk (HR 1.02; 95%CI 0.73-1.42). Similarly, compared to those who had a positive Ureaplasma culture but did not receive treatment, those who had a positive Ureaplasma culture and received treatment did not have a decreased risk (HR 0.90; 95%CI 0.65-1.25). Individuals who had Ureaplasma culture for recurrent pregnancy loss compared to those who had Ureaplasma culture for a history of preterm birth had a decreased risk (HR 0.54; 95%CI 0.35-0.85). Secondary outcomes are presented in Table 3. There were no differences in secondary outcomes across the groups.
Of 308 individuals who had a positive Ureaplasma culture and received treatment, 234 (76%) had a follow-up Ureaplasma culture. The overall treatment failure rate after the initial treatment was 78.6% (184/234; 95%CI 72.8-83.7%). Rates of treatment failure according to reasons for Ureaplasma culture are presented in Table 4. Compared to a history of preterm births, cerclage was associated with decreased odds of treatment failure (odds ratio 0.33; 95%CI 0.18-0.61).