Ureaplasma screening for pregnant individuals who are at high risk for preterm birth: a retrospective study

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