Neither Mycoplasma genitalium nor Chlamydia trachomatis in early pregnancy are associated with spontaneous abortion among young women recruited from an urban emergency department

Objectives: Spontaneous abortion (SAB), loss of a conceptus prior to 20 weeks, is the most common adverse pregnancy outcome. As genital tract infections may cause SABs and the prevalence and consequences of the sexually transmitted pathogen Mycoplasma genitalium (Mg) in pregnant women is unknown, we assessed the relationship between prenatal Mg infection and SAB.

Methods: We conducted a nested case-control study among predominately young, African-American pregnant women recruited from an urban emergency department. Mg was measured by polymerase chain reaction in urine collected at enrollment from 82 women who subsequently experienced a SAB and 134 control women who maintained their pregnancies past 22 weeks gestation. Clinical, demographic and behavioral characteristics of cases and controls were compared. The relationship between Mg and subsequent SAB was evaluated, adjusting for age, smoking, Chlamydia trachomatis (Ct) infection, and previous SAB.

Results: The prevalence of Mg at enrollment was only slightly less than that of Ct (5.6% vs. 6.9%). Neither Mg (AOR 0.6, 95% CI 0.1-2.3) nor Ct (AOR 0.4 95% CI 0.1-1.6) were independently associated with SAB. After adjusting for Ct, Mg was associated with nulliparity (AOR 3.4, 95% CI 1.0-11.6), history of pelvic inflammatory disease (PID) (AOR 3.9, 95% CI 0.9-16.1), prior Ct infection (AOR 3.0, 95% CI 0.8-10.5) and problems getting pregnant (AOR 4.8, 95% CI 0.9-25.7), although not all relationships were statistically significant.

Conclusions: Out study suggests pregnant women infected with Mg don't have an increased risk of SAB, but report a history of reproductive morbidities, including other STDs and PID.