Maternal STIs closely associated with increased risk of Preterm Births: JAMA

According to a new study, maternal sexually transmitted infections (gonorrhoea, syphilis, or chlamydia) are linked to an increased risk of preterm birth. Pregnant women who have had sexually transmitted infections before or during their pregnancy may benefit from targeted preterm birth prevention.

This study was conducted by Rui Gao & team and the findings of this study were published in the Journal of American Medical Association on 29th November, 2021.

Through an intrauterine inflammatory response, maternal infection has been linked to the pathogenesis of preterm birth. Chlamydia, gonorrhoea, and syphilis are among the most common sexually transmitted infections in the world, but research on their relationship with preterm birth is limited. Therefore the objective of this study was to look at the link between maternal chlamydia, gonorrhoea, and syphilis infections during pregnancy and the risk of preterm birth in a large population-based study in the United States.

Between 2016 and 2019, this population-based retrospective cohort study examined nationwide birth certificate data from the US National Vital Statistics System. The study included all mothers who had a singleton live birth and had available data on chlamydia, gonorrhoea, or syphilis infection before or during pregnancy, as well as gestational age at birth. This study focused on sexually transmitted infections (chlamydia, gonorrhoea, or syphilis) that occurred before or during pregnancy. Preterm birth, defined as a gestational age of less than 37 weeks, was one of the study's main outcomes and measures.

Major findings of this study are:

1. In this study, 14 373 023 mothers participated. 267 260 (1.9%) of the mothers had chlamydia, 43 147 (0.3%) had gonorrhoea, and 16 321 (0.1%) had syphilis.

2. Preterm births accounted for 1 146 800 (8.0%) of all newborns.

3. Preterm birth occurred at a rate of 9.9%, 12.2%, and 13.3%in women infected with chlamydia, gonorrhoea, or syphilis, respectively.

4. After controlling for sociodemographic and medical and/or health factors, the adjusted odds ratio of preterm birth was 1.03 for chlamydia, 1.11 for gonorrhoea, 1.17 for syphilis, and 1.06 for any of these sexually transmitted infections when comparing mothers with and without these conditions.

In conclusion, maternal STIs of chlamydia, gonorrhoea, and syphilis were associated with an increased risk of preterm birth, particularly moderately and very preterm birth, in this large national study in the United States. These findings suggest that pregnant women who have STIs before or during pregnancy should be targeted for preterm birth prevention. Future research is required to understand the underlying mechanisms.

Reference:

Gao R, Liu B, Yang W, et al. Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States. JAMA Netw Open. 2021;4(11):e2133413. doi:10.1001/jamanetworkopen.2021.33413