scholarly journals Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

2020 ◽  
pp. sextrans-2020-054631
Author(s):  
Dorothy Chiwoniso Nyemba ◽  
Andrew Medina-Marino ◽  
Remco P H Peters ◽  
Jeffrey D Klausner ◽  
Phuti Ngwepe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Syndromic Management ◽  
Younger Age ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Associated Risk Factors ◽  
Pregnancy And Birth

ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

scholarly journals Genital Chlamydia Trachomatis Infection: Prevalence, Risk Factors and Adverse Pregnancy and Birth Outcomes in Children and Women in sub-Saharan Africa

2021 ◽  
Vol 10 (2) ◽  
pp. 251-257
Author(s):  
Elizabeth Afibah Armstrong-Mensah ◽  
David-Praise Ebiringa ◽  
Kaleb Whitfield ◽  
Jake Coldiron
Keyword(s):  
Risk Factors ◽  
Chlamydia Trachomatis ◽  
Birth Outcomes ◽  
Cultural Practices ◽  
Sub Saharan Africa ◽  
Pregnancy And Birth Outcomes ◽  
Women And Children ◽  
Sub Saharan ◽  
Adverse Pregnancy ◽  
Pregnancy And Birth

Genital Chlamydia trachomatis (CT) has adverse health outcomes for women and children. In pregnant women, the infection causes adverse obstetric outcomes including pelvic inflammation, ectopic pregnancy, and miscarriage. In children, it causes adverse birth outcomes such as skin rash, lesions, limb abnormalities, conjunctivitis, neurological damage, and even death. This article discusses genital CT prevalence, risk factors, and adverse pregnancy and birth outcomes among women and children in sub-Saharan Africa as well as challenges associated with the mitigation of the disease. A comprehensive search of databases including PubMed, ResearchGate, and Google Scholar was conducted using keywords such as genital chlamydia trachomatis, adverse pregnancy outcomes, adverse birth outcomes, and sub-Saharan African. We found that genital CT prevalence rates in some sub-Saharan Africa countries were higher than others and that risk factors such as the lack of condom use, having multiple sexual partners, and low educational levels contribute to the transmission of the infection. We also found that negative cultural practices, illiteracy among women, and the lack of access to screening services during pregnancy are some of the challenges associated with CT mitigation in sub-Saharan Africa. To reduce genital CT transmission in sub-Saharan Africa, efforts must be made by country governments to eliminate negative cultural practices, promote female literacy, and provide access to screening services for pregnant women.   Copyright © 2021 Armstrong-Mensah et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.

Adverse pregnancy and birth outcomes by infertility diagnoses with and without ART treatment

2014 ◽  
Vol 102 (3) ◽  
pp. e336
Author(s):  
J.E. Stern ◽  
B. Luke ◽  
M. Tobias ◽  
M.D. Hornstein ◽  
H. Diop
Keyword(s):  
Birth Outcomes ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Pregnancy And Birth

scholarly journals Maternal dietary patterns and risk of adverse pregnancy (hypertensive disorders of pregnancy and gestational diabetes mellitus) and birth (preterm birth and low birth weight) outcomes: a systematic review and meta-analysis

2018 ◽  
Vol 22 (3) ◽  
pp. 506-520 ◽  
Author(s):  
Kelemu Tilahun Kibret ◽  
Catherine Chojenta ◽  
Ellie Gresham ◽  
Teketo K Tegegne ◽  
Deborah Loxton
Keyword(s):  
Diabetes Mellitus ◽  
Birth Outcomes ◽  
Dietary Patterns ◽  
Meta Analysis ◽  
Whole Grains ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Pregnancy And Birth

AbstractObjectiveEpidemiological studies have indicated that dietary patterns during pregnancy are associated with adverse pregnancy and birth outcomes such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), preterm birth (PTB) and low birth weight (LBW). However, the results of these studies are varied and inconsistent. The present study aimed to assess the association between dietary patterns and the risk of adverse pregnancy and birth outcomes.DesignSystematic review and meta-analysis. Seven databases were searched for articles. Two reviewers performed the study selection and data extraction. A random-effects model was used to estimate pooled effect sizes of eligible studies.SettingStudies conducted all over the world were incorporated.SubjectsThe review focused on pregnant women.ResultsA total of twenty-one studies were identified. Adherence to a healthy dietary pattern (intake of vegetables, fruits, legumes, whole grains) was significantly associated with lower odds (OR; 95 % CI) of pre-eclampsia (0·78; 0·70, 0·86; I2=39·0 %, P=0·178), GDM (0·78; 0·56, 0·99; I2=68·6 %, P=0·013) and PTB (0·75; 0·57, 0·93; I2=89·6 %, P=0·0001).ConclusionsOur review suggests that dietary patterns with a higher intake of fruits, vegetables, legumes, whole grains and fish are associated with a decreased likelihood of adverse pregnancy and birth outcomes. Further research should be conducted in low-income countries to understand the impact of limited resources on dietary intake and adverse pregnancy and birth outcomes.

scholarly journals Correction to: Air Pollution and Adverse Pregnancy and Birth Outcomes: Mediation Analysis Using Metabolomic Profiles

2020 ◽  
Vol 7 (4) ◽  
pp. 441-441
Author(s):  
Kosuke Inoue ◽  
Qi Yan ◽  
Onyebuchi A. Arah ◽  
Kimberly Paul ◽  
Douglas I. Walker ◽  
...  
Keyword(s):  
Air Pollution ◽  
Birth Outcomes ◽  
Mediation Analysis ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Pregnancy And Birth

scholarly journals A Review of the Potential Benefits of Increasing Vitamin D Status in Mongolian Adults through Food Fortification and Vitamin D Supplementation

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2452 ◽  
Author(s):  
William B. Grant ◽  
Barbara J. Boucher
Keyword(s):  
Vitamin D ◽  
Birth Outcomes ◽  
Mortality Rates ◽  
Malignant Neoplasms ◽  
Supplement Use ◽  
Incidence And Mortality ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Tract Infections ◽  
Pregnancy And Birth

Serum 25-hydroxyvitamin D (25(OH)D) concentrations are low in Mongolia, averaging 22 ng/mL in summer and only 8 ng/mL in winter. Mongolians have high incidence and/or prevalence of several diseases linked to low 25(OH)D concentrations, including ischemic heart disease, malignant neoplasms, cirrhosis of the liver, ischemic stroke, lower respiratory tract infections, preterm birth complications, and diabetes mellitus. Fortifying regularly consumed foods such as flour, milk, and edible oils with vitamin D3 could raise 25(OH)D concentrations by about 10 ng/mL. However, to achieve 25(OH)D concentrations of 30–40 ng/mL in adults, vitamin D intakes of 1000 to 4000 IU/day would be required, making personal supplement use necessary. On the basis of prospective observational studies and clinical trials of disease incidence or known mortality rates and adverse pregnancy and birth outcomes, raising mean serum 25(OH)D concentrations to 40 ng/mL would likely reduce incidence and mortality rates for those and other diseases, reduce the rate of adverse pregnancy and birth outcomes, and increase mean life expectancy by one year or more.

scholarly journals The SNAP trial: a randomised placebo-controlled trial of nicotine replacement therapy in pregnancy – clinical effectiveness and safety until 2 years after delivery, with economic evaluation

2014 ◽  
Vol 18 (54) ◽  
pp. 1-128 ◽  
Author(s):  
Sue Cooper ◽  
Sarah Lewis ◽  
James G Thornton ◽  
Neil Marlow ◽  
Kim Watts ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Replacement Therapy ◽  
Nicotine Replacement Therapy ◽  
Clinical Effectiveness ◽  
Nicotine Replacement ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Pregnancy And Birth ◽  
In Pregnancy

BackgroundSmoking during pregnancy causes many adverse pregnancy and birth outcomes. Nicotine replacement therapy (NRT) is effective for cessation outside pregnancy but efficacy and safety in pregnancy are unknown. We hypothesised that NRT would increase smoking cessation in pregnancy without adversely affecting infants.ObjectivesTo compare (1) at delivery, the clinical effectiveness and cost-effectiveness for achieving biochemically validated smoking cessation of NRT patches with placebo patches in pregnancy and (2) in infants at 2 years of age, the effects of maternal NRT patch use with placebo patch use in pregnancy on behaviour, development and disability.DesignRandomised, placebo-controlled, parallel-group trial and economic evaluation with follow-up at 4 weeks after randomisation, delivery and until infants were 2 years old. Randomisation was stratified by centre and a computer-generated sequence was used to allocate participants using a 1 : 1 ratio. Participants, site pharmacies and all study staff were blind to treatment allocation.SettingSeven antenatal hospitals in the Midlands and north-west England.ParticipantsWomen between 12 and 24 weeks’ gestation who smoked ≥ 10 cigarettes a day before and ≥ 5 during pregnancy, with an exhaled carbon monoxide (CO) reading of ≥ 8 parts per million (p.p.m.).InterventionsNRT patches (15 mg per 16 hours) or matched placebo as an 8-week course issued in two equal batches. A second batch was dispensed at 4 weeks to those abstinent from smoking.Main outcome measuresParticipants: self-reported, prolonged abstinence from smoking between a quit date and childbirth, validated at delivery by CO measurement and/or salivary cotinine (COT) (primary outcome). Infants, at 2 years: absence of impairment, defined as no disability or problems with behaviour and development. Economic: cost per ‘quitter’.ResultsOne thousand and fifty women enrolled (521 NRT, 529 placebo). There were 1010 live singleton births and 12 participants had live twins, while there were 14 fetal deaths and no birth data for 14 participants. Numbers of adverse pregnancy and birth outcomes were similar in trial groups, except for a greater number of caesarean deliveries in the NRT group. Smoking: all participants were included in the intention-to-treat (ITT) analyses; those lost to follow-up (7% for primary outcome) were assumed to be smoking. At 1 month after randomisation, the validated cessation rate was higher in the NRT group {21.3% vs. 11.7%, odds ratio [OR], [95% confidence interval (CI)] for cessation with NRT, 2.05 [1.46 to 2.88]}. At delivery, there was no difference between groups’ smoking cessation rates: 9.4% in the NRT and 7.6% in the placebo group [OR (95% CI), 1.26 (0.82 to 1.96)]. Infants: at 2 years, analyses were based on data from 888 out of 1010 (87.9%) singleton infants (including four postnatal infant deaths) [445/503 (88.5%) NRT, 443/507 (87.4%) placebo] and used multiple imputation. In the NRT group, 72.6% (323/445) had no impairment compared with 65.5% (290/443) in placebo (OR 1.40, 95% CI 1.05 to 1.86). The incremental cost-effectiveness ratio for NRT use was £4156 per quitter (£4926 including twins), but there was substantial uncertainty around these estimates.ConclusionsNicotine replacement therapy patches had no enduring, significant effect on smoking in pregnancy; however, 2-year-olds born to women who used NRT were more likely to have survived without any developmental impairment. Further studies should investigate the clinical effectiveness and safety of higher doses of NRT.Trial registrationCurrent Controlled Trials ISRCTN07249128.FundingThis project was funded by the NIHR Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 18, No. 54. See the NIHR Journals Library programme website for further project information.

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