Chlamydia, Gonorrhea, and Incident HIV Infection During Pregnancy Predict Preterm Birth Despite Treatment.
J Infect Dis
; 224(12): 2085-2093, 2021 12 15.
Article
em En
| MEDLINE
| ID: mdl-34023871
ABSTRACT
BACKGROUND:
Identifying predictors of preterm birth (PTB) in high-burden regions is important as PTB is the leading cause of global child mortality.METHODS:
This analysis was nested in a longitudinal study of human immunodeficiency virus (HIV) incidence in Kenya. HIV-seronegative women enrolled in pregnancy had nucleic acid amplification tests (chlamydia and gonorrhea), rapid plasma reagin (syphilis), wet mount microscopy (Trichomonas and yeast), and Gram stain (bacterial vaginosis); sexually transmitted infection (STI) treatment was provided. PTB predictors were determined using log-binomial regression.RESULTS:
Among 1244 mothers of liveborn infants, median gestational age at enrollment was 26 weeks (IQR, 22-31), and at delivery was 39.1 weeks (IQR, 37.1-40.9). PTB occurred in 302 women (24.3%). Chlamydia was associated with a 1.59-fold (P = .006), gonorrhea a 1.62-fold (P = .04), and incident HIV a 2.08-fold (P = .02) increased PTB prevalence. Vaginal discharge and cervical inflammation were associated with PTB, as were age ≤21 (prevalence ratio [PR] = 1.39, P = .001) and any STI (PR = 1.47, P = .001). Associations with chlamydia and incident HIV remained in multivariable models.CONCLUSIONS:
STIs and incident HIV in pregnancy predicted PTB despite treatment, suggesting the need for earlier treatment and interventions to decrease genital inflammation.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Infecciosas na Gravidez
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Trichomonas vaginalis
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Infecções por Chlamydia
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Gonorreia
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Infecções por HIV
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Chlamydia
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Nascimento Prematuro
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Neisseria gonorrhoeae
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Child
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Female
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Humans
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Infant
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Newborn
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Pregnancy
Idioma:
En
Revista:
J Infect Dis
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos