Objective: To evaluate the impact of Mycoplasma genitalium on the outcome of pregnancy. Methods: Cervical samples from women who had previously participated in a case-control study (designed to assess the impact of syphilis and HIV-2 on the outcome of pregnancy in Guinea-Bissau) were processed using a PCR assay to detect the presence of M genitalium. Controls were women who had delivered a term neonate with a birth weight over 2500 g. Cases were classified into four groups of mothers according to the outcome of pregnancy: stillbirths, spontaneous abortions, premature deliveries, and small for gestational age (SGA) babies. Results: Among the 1014 women included in this study, 6.2% were infected with M genitalium. M genitalium infection was not significantly associated with any of the adverse outcomes of pregnancy studied. Odds ratios (OR) for premature or SGA delivery in the presence of M genitalium infection were 1.37 (95% CI 0.69 to 2.60) and 0.44 (95% CI 0.01 to 2.75), respectively. For abortions and stillbirths, OR were respectively 0.61 (95% CI 0.07 to 2.51) and 1.07 (95% CI 0.42 to 2.42). Conclusion: M genitalium appears not to have a deleterious impact on the outcome of pregnancy.M ycoplasma genitalium has recently been shown to be strongly associated with non-gonococcal urethritis (NGU) in developed and developing countries, and increasing evidence supports the role of this organism in the aetiology of NGU. [1][2][3][4] This pathogen has also been detected by polymerase chain reaction (PCR) in the lower genital tract of 7-20% of women attending sexually transmitted diseases (STD) clinics.1 5 M genitalium was found in seven (6.6%) of 106 women with chlamydia negative cervicitis or adnexitis but in none of 80 pregnant asymptomatic women. 6 The involvement of M genitalium in pelvic inflammatory disease (PID) remains unclear: it adheres to fallopian tube epithelial cells in culture 1 and produces salpingitis in animal models, 1 but more studies in women are needed. 4 The role of M genitalium in maternal infections and its impact on the outcome of pregnancy has only been sparsely evaluated. The first published study conducted among pregnant women failed to detect this organism by culture and PCR in 232 samples of amniotic fluid collected at the time of caesarean delivery.7 More recently, M genitalium was found in only 5/124 women who delivered prematurely and its presence in the vagina at mid-trimester was not found to be associated with subsequent spontaneous preterm birth. 8 We have developed a modified version of Jensen's PCR method for the detection of M genitalium 5 to study the aetiology of urethral discharge in sub-Saharan Africa.2 3 To elucidate the potential contribution of M genitalium to adverse outcomes of pregnancy, we used the same PCR assay to detect the presence of M genitalium in cervical secretions of women who had participated in a study initially designed to assess the impact of syphilis and HIV-2 on the outcome of pregnancy in west Africa. METHODSFrom June 1997 to April 1998, we conducted...

Initial exposure to human immunodeficiency virus type 1 (HIV-1) during heterosexual transmission occurs in the genital tract.

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