The Impact of Neisseria gonorrhoeae Mono- and Coinfection on Adverse Pregnancy Outcomes

Author:

Taylor Brandie DePaoli123ORCID,Adekanmbi Victor13,Zhang Yuanyi4,Berenson Abbey13

Affiliation:

1. Department of Obstetrics and Gynecology, University of Texas Medical Branch , Galveston, Texas , USA

2. Department of Population Health and Health Disparities, University of Texas Medical Branch , Galveston, Texas , USA

3. Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch , Galveston, Texas , USA

4. Department of Biostatistics and Data Science, University of Texas Medical Branch , Galveston, Texas , USA

Abstract

Abstract Background Sexually transmitted infections (STIs) have recently been linked to hypertensive disorders of pregnancy (HDP). However, the impact of Neisseria gonorrhoeae 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. Methods 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. Results 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). Conclusions 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.

Funder

National Institutes of Allergy and Infectious Diseases

Building Interdisciplinary Research Careers in Women’s Health Program [BIRCWH]

National Institutes of Health/Office of the Director, NIAID

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Oncology

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