博茨瓦纳哈博罗内市产前检查与筛查对产后患病率及垂直传播的影响：一项探索性研究的结果
Effect of antenatal and screening on postdelivery prevalence and vertical transmission in Gaborone, Botswana: findings from an exploratory study.
作者信息
Mussa Aamirah, Wynn Adriane, Ryan Rebecca, Babalola Chibuzor M, Hansman Emily, Simon Selebaleng, Bame Bame, Moshashane Neo, Masole Maitumelo, Wilson Melissa L, Klausner Jeffrey D, Morroni Chelsea
机构信息
Botswana Harvard Health Partnership, Gaborone, Botswana
Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK.
出版信息
Sex Transm Infect. 2025 Mar 24;101(2):81-87. doi: 10.1136/sextrans-2023-055965.
OBJECTIVES
and are common sexually transmitted infections (STIs). Untreated infection in pregnancy can result in adverse neonatal outcomes, including vertical transmission. Screening for these infections is not routine in low- and middle-income countries (LMICs).
METHODS
The Maduo Study was a non-randomised cluster crossover trial in Botswana to provide preliminary data on the effect of antenatal and screening and treatment on postdelivery prevalence and vertical transmission to infants. Pregnant women asymptomatic for STIs were enrolled at four clinics (seven clusters). The intervention arm received and screening at first antenatal care, third trimester and postdelivery. The standard-of-care arm received postdelivery screening only. Infants of women with a positive test postdelivery in both arms were screened. A cluster-level analysis was performed to compare the risk of postdelivery infection between intervention and standard-of-care arms.
RESULTS
The study enrolled 500 women; 206 (82.1%) and 187 (75.1%) were retained in the intervention and standard-of-care arms, respectively and screened ≤12 weeks postdelivery. prevalence in the intervention arm reduced from 22.7% at first antenatal care to 1.0% postdelivery. prevalence reduced from 1.2% at first antenatal care to 0% postdelivery. The risk of and/or was lower in the intervention arm postdelivery (0.6%) compared with the standard-of-care arm (15.7%); adjusted risk difference: -14.7% (95% CI -23.0%, -6.4%). Among 26 infants born to women with either infection postdelivery, 10 (38.5%) tested positive (: 9; : 1).
CONCLUSIONS
Postdelivery prevalence of was significantly lower among pregnant women in Botswana who received diagnostic antenatal screening. Among women with and/or postdelivery, more than one-third transmitted the infection to their infants. This exploratory study suggests antenatal STI screening has the potential to reduce infection in newborns in similar LMIC settings.
TRIAL REGISTRATION NUMBER
NCT04955717.
目的
[疾病名称1]和[疾病名称2]是常见的性传播感染（STIs）。孕期未经治疗的感染可导致不良新生儿结局，包括垂直传播。在低收入和中等收入国家（LMICs），对这些感染进行筛查并非常规操作。
方法
玛多研究是在博茨瓦纳进行的一项非随机整群交叉试验，旨在提供关于产前[疾病名称1]和[疾病名称2]筛查及治疗对产后患病率和向婴儿垂直传播影响的初步数据。在四个诊所（七个整群）招募了无症状性传播感染的孕妇。干预组在首次产前检查、孕晚期和产后接受[疾病名称1]和[疾病名称2]筛查。标准治疗组仅在产后接受筛查。对两组中产后检测呈阳性的妇女所生婴儿进行筛查。进行整群水平分析以比较干预组和标准治疗组产后感染风险。
结果
该研究招募了500名妇女；干预组和标准治疗组分别有206名（82.1%）和187名（75.1%）妇女被保留，并在产后≤12周进行了筛查。干预组中[疾病名称1]患病率从首次产前检查时的22.7%降至产后的1.0%。[疾病名称2]患病率从首次产前检查时的1.2%降至产后的0%。干预组产后[疾病名称1]和/或[疾病名称2]的风险（0.6%）低于标准治疗组（15.7%）；调整后的风险差异：-14.7%（95%CI -23.0%，-6.4%）。在26名产后感染[疾病名称1]或[疾病名称2]的妇女所生婴儿中，10名（38.5%）检测呈阳性（[疾病名称1]：9名；[疾病名称2]：1名）。
结论
在博茨瓦纳接受产前诊断性筛查的孕妇中，产后[疾病名称1]患病率显著降低。在产后感染[疾病名称1]和/或[疾病名称2]的妇女中，超过三分之一将感染传给了她们的婴儿。这项探索性研究表明，产前性传播感染筛查有可能在类似的低收入和中等收入国家环境中减少新生儿感染。
试验注册号
NCT04955717。
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