Document Type

Article

Publication Date

2025

DOI

10.7759/cureus.98095

Publication Title

Cureus

Volume

17

Issue

11

Pages

e98095

Abstract

Objective

We aimed to estimate the causal effect of treatment for genital Mycoplasma species on preterm birth (PTB) and spontaneous abortion (SA). We also evaluated treatment effects separately for cases with co-infection of Ureaplasma and Mycoplasma species.

Methods

This was a retrospective observational cohort study at a single center. Singleton mothers with one or more risk factors for PTBs were screened and treated for genital Mycoplasma species. The treatment was repeated based on polymerase chain reaction (PCR) results after each course. We applied inverse probability treatment weighting, and risk differences (RDs) of the treatment effect on pregnancy outcomes were estimated with the generalized estimating equations. A combination of PTB and SA was used as the primary outcome. Secondary analysis was conducted, focusing on treatment for co-infection of both Mycoplasma and Ureaplasma species.

Results

From January 2014 to December 2020, 696 individuals tested positive for genital Mycoplasma species. Of the individuals, 566 were treated with azithromycin, whereas 62 were not. Among them, 269 received a second treatment, whereas 40 did not. The first treatment effect on PTB and SA was RD (95% CI) of 0.037 (-0.104, 0.178), and the second treatment effect was RD (95% CI) of -0.049 (-0.220, 0.123). When focusing on coinfection of Ureaplasma and Mycoplasma, the first effect was RD (95% CI) of -0.005 (-0.274, 0.264), and the second treatment effect was RD (95% CI) of -0.545 (-0.739, -0.350).

Conclusions

Routine treatment for genital Mycoplasma species is not recommended. However, the results suggest potential benefits in treating co-infections.

Rights

© Copyright 2025

This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Original Publication Citation

Yoshimasu, T., Inao, T., & Kawakita, T. (2025). Treatment effects of genital mycoplasma species in high-risk pregnant individuals: A retrospective cohort study. Cureus, 17(11), Article e98095. https://doi.org/10.7759/cureus.98095

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