Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States

Rui Gao; Buyun Liu; Wenhan Yang; Yuxiao Wu; Bo Wang; Mark K Santillan; Kelli Ryckman; Donna A Santillan; Wei Bao

doi:10.1001/jamanetworkopen.2021.33413

Back

Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States

Journal article

Open access

Peer reviewed

Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States

Rui Gao, Buyun Liu, Wenhan Yang, Yuxiao Wu, Bo Wang, Mark K Santillan, Kelli Ryckman, Donna A Santillan and Wei Bao

JAMA network open, Vol.4(11), pp.e2133413-e2133413

11/01/2021

DOI: 10.1001/jamanetworkopen.2021.33413

PMCID: PMC8630565

PMID: 34842927

Files and links (1)

url

https://doi.org/10.1001/jamanetworkopen.2021.33413View

Published (Version of record) Open Access

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.

Pregnancy

United States

Adult

Causality

Chlamydia Infections - epidemiology

Cohort Studies

Female

Gonorrhea - epidemiology

Humans

Infant, Newborn

Pregnancy Complications, Infectious - epidemiology

Premature Birth - epidemiology

Premature Birth - etiology

Retrospective Studies

Risk Factors

Sexually Transmitted Diseases - epidemiology

Syphilis - epidemiology

Details

Title: Subtitle: Association of Maternal Sexually Transmitted Infections With Risk of Preterm Birth in the United States
Creators: Rui Gao - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Buyun Liu - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Wenhan Yang - Department of Maternal and Child Health, Sun Yat-sen University School of Public Health, Guangzhou, Guangdong Province, China
Yuxiao Wu - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Bo Wang - Department of Pediatrics, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China
Mark K Santillan - Center for Hypertension Research, University of Iowa, Iowa City
Kelli Ryckman - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Donna A Santillan - Center for Hypertension Research, University of Iowa, Iowa City
Wei Bao - Department of Epidemiology, University of Iowa College of Public Health, Iowa City
Resource Type: Journal article
Publication Details: JAMA network open, Vol.4(11), pp.e2133413-e2133413
DOI: 10.1001/jamanetworkopen.2021.33413
PMID: 34842927
PMCID: PMC8630565
NLM abbreviation: JAMA Netw Open
ISSN: 2574-3805
eISSN: 2574-3805
Language: English
Date published: 11/01/2021
Academic Unit: Stead Family Department of Pediatrics; Epidemiology; Obstetrics and Gynecology; Fraternal Order of Eagles Diabetes Research Center
Record Identifier: 9984216738102771

Metrics

25 Record Views

43 Times Cited - Web of Science