Taylor Brandie DePaoli, Adekanmbi Victor, Zhang Yuanyi, Berenson Abbey
Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas, USA.
Department of Population Health and Health Disparities, University of Texas Medical Branch, Galveston, Texas, USA.
Open Forum Infect Dis. 2023 Apr 21;10(5):ofad220. doi: 10.1093/ofid/ofad220. eCollection 2023 May.
Sexually transmitted infections (STIs) have recently been linked to hypertensive disorders of pregnancy (HDP). However, the impact of on risk of HDP is not well understood. This study determined the impact of gonorrhea and gonorrhea coinfection on HDP and other adverse pregnancy outcomes in a population with a high screening rate and presumed treatment.
This retrospective study included 29 821 singleton births between 2016 and 2021. The STI testing results, demographic variables, and pregnancy outcomes were identified from electronic health records. The HDP were primary outcomes of interest including gestational hypertension, preeclampsia, and superimposed preeclampsia. We further examined preeclampsia subtypes defined by severe features and gestational age of delivery (term and preterm preeclampsia). Secondary outcomes included preterm premature rupture of membranes, chorioamnionitis, and preterm delivery. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Models were adjusted for maternal age, maternal race/ethnicity, and smoking.
Gonorrhea screening occurred in 95% of the population. Gonorrhea increased the odds of preterm preeclampsia (adjusted OR [ORadj.], 1.95; 95% CI, 1.02-3.73) and preterm birth (ORadj., 1.78; 95% CI, 1.22-2.60). Furthermore, gonorrhea-chlamydia coinfection was associated with preterm birth (ORadj., 1.77; 95% CI, 1.03-3.04). However, results were similar when we examined gonorrhea monoinfection (ORadj., 1.76; 95% CI, 1.04-2.97).
Among a diverse population of pregnant individuals, gonorrhea increased odds of preterm preeclampsia and preterm delivery Further research is needed to determine the burden of STIs on HDP, including investigations into biological effects during pregnancy.
性传播感染（STIs）最近被认为与妊娠期高血压疾病（HDP）有关。然而，其对HDP风险的影响尚未得到充分了解。本研究确定了淋病及淋病合并感染对筛查率高且假定接受治疗人群中HDP及其他不良妊娠结局的影响。
这项回顾性研究纳入了2016年至2021年间的29821例单胎分娩。从电子健康记录中获取性传播感染检测结果、人口统计学变量和妊娠结局。HDP是主要关注结局，包括妊娠期高血压、先兆子痫和叠加性先兆子痫。我们进一步检查了根据严重特征和分娩孕周（足月和早产先兆子痫）定义的先兆子痫亚型。次要结局包括胎膜早破、绒毛膜羊膜炎和早产。采用逻辑回归计算比值比（ORs）和95%置信区间（CIs）。模型对产妇年龄、产妇种族/族裔和吸烟情况进行了校正。
95%的人群进行了淋病筛查。淋病增加了早产先兆子痫（校正OR[ORadj.]，1.95；95%CI，1.02 - 3.73）和早产（ORadj.，1.78；95%CI，1.22 - 2.60）的几率。此外，淋病 - 衣原体合并感染与早产有关（ORadj.，1.77；95%CI，1.03 - 3.04）。然而，当我们检查单纯淋病感染时结果相似（ORadj.，1.76；95%CI，1.04 - 2.97）。
在不同的孕妇群体中，淋病增加了早产先兆子痫和早产的几率。需要进一步研究以确定性传播感染对HDP的负担，包括对孕期生物学效应的调查。
