{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T10:37:28Z","timestamp":1786617448446,"version":"build-2736575974"},"posted":{"date-parts":[[2026,8,11]]},"group-title":"Epidemiology","reference-count":31,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"award":["197381"],"award-info":[{"award-number":["197381"]}],"id":[{"id":"https:\/\/ror.org\/00yjd3n13","id-type":"ROR","asserted-by":"publisher"}]},{"award":["197381"],"award-info":[{"award-number":["197381"]}],"id":[{"id":"https:\/\/ror.org\/00yjd3n13","id-type":"ROR","asserted-by":"publisher"}]},{"award":["R01AI149339"],"award-info":[{"award-number":["R01AI149339"]}],"id":[{"id":"https:\/\/ror.org\/043z4tv69","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,8,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    Sexually transmitted infections (STIs) and vaginal dysbiosis during pregnancy are associated with adverse pregnancy outcomes.\n                    <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                    is the most recent STI implicated but evidence remains limited. The objectives of this study were to investigate 1) the association between\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    infection during pregnancy and gestational age at delivery, preterm birth, miscarriage or stillbirth, and low birth weight and 2) the interaction with vaginal dysbiosis.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    We conducted a prospective cohort study in East London, South Africa. We enrolled pregnant women at gestational age &lt;27 weeks, confirmed by ultrasound. We tested vaginal samples using nucleic acid amplification tests for\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    ,\n                    <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                    ,\n                    <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                    ,\n                    <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                    , other genital mycoplasmas and\n                    <jats:italic>Candida<\/jats:italic>\n                    spp. We defined vaginal dysbiosis using Gram-stain criteria as a Nugent score 4-10. We used quantile regression to compare the outcome in women with and without\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    across the gestational age distribution, adjusting for prespecified sociodemographic and clinical characteristics and co-occurring organisms.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    From April 1, 2021 to August 29, 2023, we enrolled 603 women, followed up 584 and obtained pregnancy outcomes for 560 (93%). Median age was 28 years (interquartile range, IQR 24, 33) and 27% of women were living with HIV.\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    was detected in 44\/584 (8%, 95% CI 6, 10%) and vaginal dysbiosis in 375\/584 (64%) of women. Median gestational age at delivery was 39 weeks +0 days (IQR 37+4, 40+1) in women with and 39 weeks +0 days (37+4, 40+0) in those without\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    . In multivariable models, associations were not observed for any adverse birth outcomes. There was no interaction between\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    and vaginal dysbiosis.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    in pregnancy was not associated with earlier gestational age at delivery or with other adverse birth outcomes. These findings do not support routine testing and treatment for\n                    <jats:italic>M. genitalium<\/jats:italic>\n                    in pregnancy.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.08.09.26360025","type":"posted-content","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:20:17Z","timestamp":1786443617000},"source":"Crossref","is-referenced-by-count":0,"title":["<i>Mycoplasma genitalium<\/i>\n                  infection and adverse pregnancy outcomes among pregnant women in South Africa: prospective cohort study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7926-4153","authenticated-orcid":false,"given":"Ranjana MS","family":"Gigi","sequence":"first","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland"},{"name":"Research Unit, Foundation for Professional Development, East London, South 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