Abstract
Maternal infection has been implicated in the pathogenesis of preterm birth through intrauterine inflammatory response. Chlamydia, gonorrhea, and syphilis are among the most common sexually transmitted infections worldwide, but studies on their association with preterm birth are sparse. To examine the association between maternal chlamydia, gonorrhea, and syphilis infections in pregnancy and the risk of preterm birth in a large population-based study in the US. This population-based retrospective cohort study examined nationwide birth certificate data from the US National Vital Statistics System between 2016 and 2019. All mothers who had a singleton live birth and available data on chlamydia, gonorrhea, or syphilis infection before or during pregnancy and gestational age at birth were included in analysis. Sexually transmitted infection (chlamydia, gonorrhea, or syphilis) occurring before or during pregnancy. Preterm birth, defined as gestational age less than 37 weeks. This study included 14 373 023 mothers (mean [SD] age 29 [5.8] years; Hispanic, 3 435 333 [23.9%]; non-Hispanic Asian, 912 425 [6.3%]; non-Hispanic Black, 2 058 006 [14.3%]; and non-Hispanic White, 7 386 568 [51.4%]). Among the mothers, 267 260 (1.9%) had chlamydia, 43 147 (0.3%) had gonorrhea, and 16 321 (0.1%) had syphilis. Among the newborns, 1 146 800 (8.0%) were preterm births. The rate of preterm birth was 9.9%, 12.2%, and 13.3% among women with chlamydia, gonorrhea, and syphilis infection, respectively. After adjustment for sociodemographic and medical and/or health factors, the adjusted odds ratio of preterm birth was 1.03 (95% CI, 1.02-1.04) for chlamydia, 1.11 (95% CI, 1.08-1.15) for gonorrhea, 1.17 (95% CI, 1.11-1.22) for syphilis, and 1.06 (95% CI, 1.05-1.07) for any of these sexually transmitted infections comparing mothers with these conditions and those without. Maternal sexually transmitted infections (gonorrhea, syphilis, or chlamydia) were associated with an increased risk of preterm birth. Pregnant women with sexually transmitted infections before or during pregnancy might benefit from targeted prevention for preterm birth.
Highlights
Preterm birth, defined as birth occurring before the completion of 37 weeks of gestation,[1,2] is the leading cause of neonatal morbidity and mortality worldwide.[3]
After adjustment for sociodemographic and medical and/or health factors, the adjusted odds ratio of preterm birth was 1.03 for chlamydia, 1.11 for gonorrhea, 1.17 for syphilis, and 1.06 for any of these sexually transmitted infections comparing mothers with these conditions and those without
Pregnant women with sexually transmitted infections before or during pregnancy might benefit from targeted prevention for preterm birth
Summary
Preterm birth, defined as birth occurring before the completion of 37 weeks of gestation,[1,2] is the leading cause of neonatal morbidity and mortality worldwide.[3]. Maternal infection has been implicated in the pathogenesis of preterm birth through intrauterine inflammatory response.[5,6] Chlamydia, gonorrhea, and syphilis are among the most common sexually transmitted infections (STIs) worldwide. In parallel with the upward trends in preterm birth, the surveillance reports from the US Centers for Disease Control and Prevention (CDC) showed that the prevalence of chlamydia, gonorrhea, and syphilis have been increasing nationally in the general population from 2013 through 2018 in the US.[7]. Studies with data from a large, diverse population and available information on potential confounding factors such as detailed sociodemographic information, prenatal factors, and medical and/or health factors are critical to clarifying how maternal STIs may factor into preterm birth
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
