TY - JOUR
T1 - Sexually transmitted infections and adverse birth and infant outcomes among pregnant women in rural southern India
AU - Kojima, Noah
AU - Sharma, Nandita
AU - Ravi, Kavitha
AU - Arun, Anjali
AU - Bristow, Claire C.
AU - Sethi, Sunil
AU - Klausner, Jeffrey D.
AU - Madhivanan, Purnima
N1 - Funding Information:
The authors would like to acknowledge and thank the staff at Public Health Research Institute of India, all the participants of the study, the Organization for the Development of People, Mysore, India. Xpert® CT/NG and TV testing kits were donated by Cepheid Inc (Sunnyvale, CA). We would also like to thank the UCLA Center for World Health, the Infectious Diseases Society of America Medical Scholars Program, the Japanese American Medical Association, the Japanese American Citizens League Chiyo M. Hattori Memorial Scholarship, and Team Klausner Saving Lives for supporting Noah Kojima.
Funding Information:
The Kisalaya mobile clinic project was funded by the Elizabeth Glaser Paediatric AIDS Foundation International Leadership Award to Dr. Purnima Madhivanan. The SCIL project was funded by Positive Action for Children Fund. Kojima and Madhivanan’s time was supported by the Fogarty International Center, National Institutes of Health under award number D43 TW009343 and D43 TW010540 respectively, and the University of California Global Health Institute (UCGHI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.
Funding Information:
The Kisalaya mobile clinic project was funded by the Elizabeth Glaser Paediatric AIDS Foundation International Leadership Award to Dr. Purnima Madhivanan. The SCIL project was funded by Positive Action for Children Fund. Kojima and Madhivanan’s time was supported by the Fogarty International Center, National Institutes of Health under award number D43 TW009343 and D43 TW010540 respectively, and the University of California Global Health Institute (UCGHI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders. The authors would like to acknowledge and thank the staff at Public Health Research Institute of India, all the participants of the study, the Organization for the Development of People, Mysore, India. Xpert® CT/NG and TV testing kits were donated by Cepheid Inc (Sunnyvale, CA). We would also like to thank the UCLA Center for World Health, the Infectious Diseases Society of America Medical Scholars Program, the Japanese American Medical Association, the Japanese American Citizens League Chiyo M. Hattori Memorial Scholarship, and Team Klausner Saving Lives for supporting Noah Kojima.
Publisher Copyright:
© 2018, Journal of Clinical and Diagnostic Research. All rights reserved.
PY - 2018/7
Y1 - 2018/7
N2 - Introduction: Sexually Transmitted Infections (STIs) in pregnancy have been reported to be associated with adverse birth and infant outcomes. Aim: To examine the relationship between adverse birth outcomes and select STIs in a cohort of pregnant women in rural Southern India, using stored vaginal samples. Materials and Methods: Pregnant women with (n=208) and without (n=213) adverse birth outcomes were matched on women’s age and parity. Adverse birth or infant outcomes were defined as newborns that weighed less than 2.5 kilograms, were delivered before 37 weeks of gestation, or were stillborn, died, or admitted to an intensive care unit at birth. Those women were compared to pregnant women who delivered a full-term baby that had normal birthweight. A one-tailed prevalence ratio was calculated. Mean cycle threshold values were compared between symptomatic and asymptomatic women with Trichomonas Vaginalis (TV) infection. Results: Among the 208 women with adverse birth outcomes, 22 (10.6%) tested positive for any STI: 15 (7.2%) tested positive for TV, 1 (0.5%) for Chlamydia Trachomatis (CT), 1 (0.5%) for Neisseria Gonorrhoeae (NG), 2 (1.0%) for Human Immunodeficiency Virus (HIV), and 3 (1.4%) for Hepatitis B. Among 213 women with normal birth outcomes, 14 (6.6%) tested positive for any STI, 12 (5.6%) tested positive for only TV monoinfection, 1 (0.5%) for NG monoinfection, 1 (0.5%) for every tested STI, i.e., TV, CT, and NG. In the present study, we found that women with adverse birth outcomes had a higher ratio of STIs than those without adverse birth outcomes (prevalence ratio of 1.7 {95% CI: 0.9-3.3]}. Among women who tested positive for any STI with or without adverse birth outcomes, 67.7% were asymptomatic. Among pregnant women that tested positive for TV infection, there was no difference between mean cycle threshold values between symptomatic and asymptomatic women. Conclusion: Adverse birth outcomes were more common among women with STIs. Nucleic acid amplification testing identified modest numbers of STIs among pregnant women. Many women with positive nucleic acid amplification tests were not treated for infections because they were asymptomatic.
AB - Introduction: Sexually Transmitted Infections (STIs) in pregnancy have been reported to be associated with adverse birth and infant outcomes. Aim: To examine the relationship between adverse birth outcomes and select STIs in a cohort of pregnant women in rural Southern India, using stored vaginal samples. Materials and Methods: Pregnant women with (n=208) and without (n=213) adverse birth outcomes were matched on women’s age and parity. Adverse birth or infant outcomes were defined as newborns that weighed less than 2.5 kilograms, were delivered before 37 weeks of gestation, or were stillborn, died, or admitted to an intensive care unit at birth. Those women were compared to pregnant women who delivered a full-term baby that had normal birthweight. A one-tailed prevalence ratio was calculated. Mean cycle threshold values were compared between symptomatic and asymptomatic women with Trichomonas Vaginalis (TV) infection. Results: Among the 208 women with adverse birth outcomes, 22 (10.6%) tested positive for any STI: 15 (7.2%) tested positive for TV, 1 (0.5%) for Chlamydia Trachomatis (CT), 1 (0.5%) for Neisseria Gonorrhoeae (NG), 2 (1.0%) for Human Immunodeficiency Virus (HIV), and 3 (1.4%) for Hepatitis B. Among 213 women with normal birth outcomes, 14 (6.6%) tested positive for any STI, 12 (5.6%) tested positive for only TV monoinfection, 1 (0.5%) for NG monoinfection, 1 (0.5%) for every tested STI, i.e., TV, CT, and NG. In the present study, we found that women with adverse birth outcomes had a higher ratio of STIs than those without adverse birth outcomes (prevalence ratio of 1.7 {95% CI: 0.9-3.3]}. Among women who tested positive for any STI with or without adverse birth outcomes, 67.7% were asymptomatic. Among pregnant women that tested positive for TV infection, there was no difference between mean cycle threshold values between symptomatic and asymptomatic women. Conclusion: Adverse birth outcomes were more common among women with STIs. Nucleic acid amplification testing identified modest numbers of STIs among pregnant women. Many women with positive nucleic acid amplification tests were not treated for infections because they were asymptomatic.
KW - Pregnancy
KW - Trichomonas vaginalis
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U2 - 10.7860/JCDR/2018/32378.11752
DO - 10.7860/JCDR/2018/32378.11752
M3 - Article
AN - SCOPUS:85049515316
VL - 12
SP - QC09-QC12
JO - Journal of Clinical and Diagnostic Research
JF - Journal of Clinical and Diagnostic Research
SN - 2249-782X
IS - 7
ER -