Abstract:
Objective: To examine gestational age at delivery according to
Ureaplasma cervical culture results and whether pregnant individuals
received antibiotics.
Study Design: A retrospective cohort study
Setting : Single academic institution
Population : All pregnant individuals with risk factors for
preterm birth including those with a history of preterm birth, recurrent
pregnancy loss, or pregnancy requiring cervical cerclage.
Methods : We plotted Kaplan-Meier curves to investigate the
association between the gestational age at delivery and Ureaplasma
culture results (negative; positive and treated; or positive but did not
receive the treatment). A Cox proportional regression model was used to
calculate Hazard ratio (HR) with 95% confidence intervals (95%CI),
controlling for confounders.
Main outcome: Gestational age at delivery.
Results: Of 607 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. Compared to those who had a positive
Ureaplasma culture but did not receive treatment, those who had a
negative Ureaplasma culture did not have a decreased risk (HR 1.03;
95%CI 0.74-1.44). 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 0.91; 95%CI 0.66-1.27). The treatment failure rate of Ureaplasma
after treatment was 78.6% (95%CI 72.8-83.7%).
Conclusion: Routine Ureaplasma cervical culture is not
recommended for pregnant individuals who are at high risk for preterm
birth.
This study was not funded.
Keywords:
Antibiotics- Preterm birth- Recurrence - Ureaplasma