scholarly journals Mycoplasma genitaliumamong Young, Urban Pregnant Women

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Vanessa L. Short ◽  
Jørgen S. Jensen ◽  
Deborah B. Nelson ◽  
Pamela J. Murray ◽  
Roberta B. Ness ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Pregnant Women ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Mycoplasma Genitalium ◽  
Health History ◽  
Increased Risk ◽  
History Of ◽  
The Relationship

Objective. As the consequences ofMycoplasma genitaliumin pregnant women are unknown, we examined the relationship between prenatalM. genitaliuminfection and SAB.Methods. The presence ofM. genitaliumwas determined by PCR in urine from 82 women who subsequently experienced a SAB and 134 women who maintained their pregnancies past 22 weeks gestation. The relationships betweenM. genitaliumand subsequent SAB, demographic, current pregnancy, and reproductive health history characteristics were evaluated.Results. Compared to women withoutM. genitalium, women withM. genitaliumwere more likely to report nulliparity (41.7% versus 17.4%,P=.04), history of pelvic inflammatory disease (27.3% versus 8.8%,P=.08), priorC. trachomatisinfection (63.6% versus 36.9%,P=.11,) and problems getting pregnant (18.2% versus 4.4%,P=.10).M. genitaliumwas not associated with SAB (AOR 0.9, 95% CI 0.2–3.8).Conclusions. Pregnant women who test positive forM. genitaliumdo not have an increased risk of SAB but report a history of reproductive morbidities.

scholarly journals Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients

2019 ◽  
Vol 69 (9) ◽  
pp. 1517-1525 ◽  
Author(s):  
Casper D J den Heijer ◽  
Christian J P A Hoebe ◽  
Johanna H M Driessen ◽  
Petra Wolffs ◽  
Ingrid V F van den Broek ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Reproductive Health ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Antibiotic Use ◽  
Female Infertility ◽  
Dependent Manner ◽  
Increased Risk ◽  
Ct Test

Abstract Background We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics. Methods This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models. Results We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status. Conclusions We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

scholarly journals Mycoplasma genitalium: An Emerging Cause of Pelvic Inflammatory Disease

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Catherine L. Haggerty ◽  
Brandie D. Taylor
Keyword(s):  
Tract Infection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Genital Tract ◽  
Mycoplasma Genitalium ◽  
Genital Tract Infection ◽  
Cross Sectional ◽  
Increased Risk ◽  
Upper Genital Tract Infection

Mycoplasma genitaliumis a sexually transmitted pathogen that is increasingly identified among women with pelvic inflammatory disease (PID). AlthoughChlamydia trachomatisandNeisseria gonorrhoeaefrequently cause PID, up to 70% of cases have an unidentified etiology. This paper summarizes evidence linkingM. genitaliumto PID and its long-term reproductive sequelae. Several PCR studies have demonstrated thatM. genitaliumis associated with PID, independent of gonococcal and chlamydial infection. Most have been cross-sectional, although one prospective investigation suggested thatM. genitaliumwas associated with over a thirteenfold risk of endometritis. Further, a nested case-control posttermination study demonstrated a sixfold increased risk of PID amongM. genitaliumpositive patients. Whether or notM. genitaliumupper genital tract infection results in long-term reproductive morbidity is unclear, although tubal factor infertility patients have been found to have elevatedM. genitaliumantibodies. Several lines of evidence suggest thatM. genitaliumis likely resistant to many frequently used PID treatment regimens. Correspondingly,M. genitaliumhas been associated with treatment failure following cefoxitin and doxycycline treatment for clinically suspected PID. Collectively, strong evidence suggests thatM. genitaliumis associated with PID. Further study ofM. genitaliumupper genital tract infection diagnosis, treatment and long-term sequelae is warranted.

scholarly journals Novel bacterial vaginosis-associated organisms mediate the relationship between vaginal douching and pelvic inflammatory disease

2019 ◽  
Vol 96 (6) ◽  
pp. 439-444 ◽  
Author(s):  
Tamala Gondwe ◽  
Roberta Ness ◽  
Patricia A Totten ◽  
Sabina Astete ◽  
Gong Tang ◽  
...  
Keyword(s):  
Bacterial Vaginosis ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Effect Estimate ◽  
Adult Women ◽  
Vaginal Douching ◽  
History Of ◽  
Inverse Probability Weighted ◽  
Intermediate Variables ◽  
The Relationship

ObjectivesWe sought to determine whether the relationship between a history of vaginal douching and pelvic inflammatory disease (PID) is mediated by endometrial infection with one or more novel bacterial vaginosis (BV)-associated organisms among Atopobium vaginae, the BV-associated bacterium 1 (BVAB1), neathia (Leptotrichia) amnionii and Sneathia sanguinegens.MethodsWe first conducted log-binomial regression analyses to identify risk factors for endometrial infection in 535 adolescent and adult women with clinically suspected PID in the PID Evaluation and Clinical Health (PEACH) study. We then examined whether endometrial infection by the BV-associated organisms mediated the association between a history of vaginal douching and histologically confirmed PID using inverse probability weighted marginal structural models.ResultsVaginal douching was significantly associated with endometrial infection with one or more of the targeted BV-associated organisms (relative risk (RR) 1.21, 95% CI: 1.08 to 1.35). The total effect estimate suggested that vaginal douching increased the risk of endometritis by 24% (RR 1.24, 95% CI: 1.03 to 1.49). The controlled direct effect of this association was attenuated with endometrial infection by one or more BV-associated organisms (adjusted RR (aRR) 1.00, 95% CI: 0.57 to 1.74) and endometrial infection by all four BV-associated organisms (aRR 0.95, 95% CI: 0.53 to 1.70) as intermediate variables.ConclusionsEndometrial infection with one or more of the novel BV-associated organisms partially mediated the relationship between vaginal douching and histologically confirmed endometritis in the PEACH study. Frequent vaginal douching may confer risk for endometritis through increasing the risk of endometrial infection by novel-BV-associated organisms. Other potential pathways should be explored.

Trichomonas vaginalis, endometritis and sequelae among women with clinically suspected pelvic inflammatory disease

2019 ◽  
Vol 96 (6) ◽  
pp. 436-438 ◽  
Author(s):  
Ann E Wiringa ◽  
Roberta B Ness ◽  
Toni Darville ◽  
Richard H Beigi ◽  
Catherine L Haggerty
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Trichomonas Vaginalis ◽  
Mycoplasma Genitalium ◽  
Wet Mount ◽  
History Of ◽  
Study Participants

ObjectiveTo ascertain the prevalence of Trichomonas vaginalis and investigate associations between trichomoniasis, endometritis and sequelae among women with pelvic inflammatory disease (PID).MethodsWe assessed the prevalence of trichomoniasis identified via wet mount and its association with histologically confirmed endometritis, infertility and recurrent PID among 647 women in the PID Evaluation and Clinical Health (PEACH) study. Participants were treated for clinically suspected PID and followed for a mean of 84 months for incident sequelae. Analyses were adjusted for age, race, Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and bacterial vaginosis. Additional adjustments were incorporated for history of infertility (models of pregnancy and infertility), history of PID (recurrent PID), and self-reported partner treatment and intercourse between baseline and 30-day follow-up (persistent endometritis).ResultsT. vaginalis was present in the vagina of 12.8% of women. The odds of having endometritis at baseline were twice as high among women with trichomoniasis as compared with those without (adjusted OR (AOR): 1.9, 95% CI 1.0 to 3.3). Persistent endometritis was highly prevalent at 30 days (52.1%) and more common among women with baseline trichomoniasis (AOR: 2.6, 95% CI 0.7 to 10.1), although non-significantly. Infertility and recurrent PID were more common among women with trichomoniasis, while rates of pregnancy and live birth were lower.ConclusionsT. vaginalis was frequently isolated from the vagina of women with PID in the PEACH cohort. Wet mount microscopy for the identification of motile trichomonads was standard practice at the time of the PEACH study, but likely resulted in an underestimation of true T. vaginalis prevalence. Our findings of modest, although non-significant, prospective associations between trichomoniasis and sequelae are novel and underscore the need for additional investigation into whether T. vaginalis may play an aetiological role in adverse reproductive and gynaecological outcomes.

scholarly journals Chlamydia infection as a risk factor in ectopic pregnancy: a case control study

2018 ◽  
Vol 7 (10) ◽  
pp. 4254
Author(s):  
Angela George ◽  
Shaila S.
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Case Control Study ◽  
Case Control ◽  
Chlamydia Infection ◽  
Increased Risk ◽  
History Of ◽  
Ectopic Pregnancies ◽  
Control Study

Background: Chlamydia trachomatis has been linked to 30-50% of all ectopic pregnancies, due to irreversible tissue damage.  Hence it is pertinent to explore the risk factors pertaining to Chlamydia infection and ectopic pregnancies. The aim is to study whether Chlamydia infection is a risk factor for ectopic pregnancy in comparison with early intrauterine pregnancy, and study other risk factors in ectopic pregnancyMethods: Case-control study conducted at Sree Avittom Thirunal Hospital, Thiruvananthapuram over a period of six months taking 43 subjects in each group, i.e., cases and controls. An interview followed by collection of venous blood sample was done, which was subjected to Enzyme linked immunoassay test to detect Immunoglobulin G antibodies to Chlamydia. Comparison of qualitative variables such as age, socioeconomic status, history of infertility, history of pelvic inflammatory disease, previous history of ectopic pregnancy, use of IUCD, history of IVF, use of OCP or progesterone only pills and presence of Chlamydia IgG antibodies - between two groups was analyzed by chi-square test and the strength of association expressed in terms of Odds Rati. A p-value <0.05 was considered statistically significant.Results: Out of 86 samples 54 were positive for Chlamydia infection. Subjects with Chlamydia infection had an increased risk of developing ectopic pregnancy. Among the other risk factorshistory of pelvic inflammatory disease and history of infertility were the most significant with Odds of 3.46 and 3.98 respectively. History of oral contraceptive use also had a significant risk associated with developing ectopic pregnancy. Other factors with significant association included, age more than 25 years, Upper Socioeconomic Class, previous ectopic pregnancy and history of IUCD use for more than 5 years.Conclusions: The increased number of Chlamydia infection and its increased risk for developing irreversible sequels such as ectopic pregnancy, it is pertinent to vigilantly diagnose, treat and prevent vaginal infection and pelvic inflammatory disease.

scholarly journals Pregnancy Outcomes and SARS-CoV-2 Infection: The Spanish Obstetric Emergency Group Study

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 853
Author(s):  
Sara Cruz Melguizo ◽  
María Luisa de la Cruz Conty ◽  
Paola Carmona Payán ◽  
Alejandra Abascal-Saiz ◽  
Pilar Pintando Recarte ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Perinatal Outcomes ◽  
Preterm Births ◽  
Hypertensive Disorder ◽  
Obstetric Emergency ◽  
Increased Risk ◽  
Emergency Group ◽  
Adverse Perinatal Outcomes ◽  
Maternal Disease ◽  
The Relationship

Pregnant women who are infected with SARS-CoV-2 are at an increased risk of adverse perinatal outcomes. With this study, we aimed to better understand the relationship between maternal infection and perinatal outcomes, especially preterm births, and the underlying medical and interventionist factors. This was a prospective observational study carried out in 78 centers (Spanish Obstetric Emergency Group) with a cohort of 1347 SARS-CoV-2 PCR-positive pregnant women registered consecutively between 26 February and 5 November 2020, and a concurrent sample of PCR-negative mothers. The patients’ information was collected from their medical records, and the association of SARS-CoV-2 and perinatal outcomes was evaluated by univariable and multivariate analyses. The data from 1347 SARS-CoV-2-positive pregnancies were compared with those from 1607 SARS-CoV-2-negative pregnancies. Differences were observed between both groups in premature rupture of membranes (15.5% vs. 11.1%, p < 0.001); venous thrombotic events (1.5% vs. 0.2%, p < 0.001); and severe pre-eclampsia incidence (40.6 vs. 15.6%, p = 0.001), which could have been overestimated in the infected cohort due to the shared analytical signs between this hypertensive disorder and COVID-19. In addition, more preterm deliveries were observed in infected patients (11.1% vs. 5.8%, p < 0.001) mainly due to an increase in iatrogenic preterm births. The prematurity in SARS-CoV-2-affected pregnancies results from a predisposition to end the pregnancy because of maternal disease (pneumonia and pre-eclampsia, with or without COVID-19 symptoms).

scholarly journals Mycoplasma Genitalium Among Women With Nongonococcal, Nonchlamydial Pelvic Inflammatory Disease

2006 ◽  
Vol 2006 ◽  
pp. 1-5 ◽  
Author(s):  
Catherine L. Haggerty ◽  
Patricia A. Totten ◽  
Sabina G. Astete ◽  
Roberta B. Ness
Keyword(s):  
Chlamydia Trachomatis ◽  
Pelvic Inflammatory Disease ◽  
Young Women ◽  
Inflammatory Disease ◽  
Plasma Cells ◽  
Mycoplasma Genitalium ◽  
Pelvic Organ ◽  
Etiologic Agent ◽  
Surface Epithelium ◽  
Pilot Sample

Pelvic inflammatory disease (PID) is a frequent condition of young women, often resulting in reproductive morbidity. Although Neisseria gonorrhoeae and/or Chlamydia trachomatis are/is recovered from approximately a third to a half of women with PID, the etiologic agent is often unidentified. We need PCR to test for M genitalium among a pilot sample of 50 women with nongonococcal, nonchlamydial endometritis enrolled in the PID evaluation and clinical health (PEACH) study. All participants had pelvic pain, pelvic organ tenderness, and leukorrhea, mucopurulent cervicitis, or untreated cervicitis. Endometritis was defined as≥5 surface epithelium neutrophils per×400field absent of menstrual endometrium and/or≥2 stromal plasma cells per×120field. We detected M genitalium in 7 (14%) of the women tested: 6 (12%) in cervical specimens and 4 (8%) in endometrial specimens. We conclude that M genitalium is prevalent in the endometrium of women with nongonococcal, nonchlamydial PID.

scholarly journals Low serum selenium in pregnancy is associated with reduced T3 and increased risk of GDM

2021 ◽  
Vol 248 (1) ◽  
pp. 45-57
Author(s):  
Pierre Hofstee ◽  
Janelle James-McAlpine ◽  
Daniel R McKeating ◽  
Jessica J Vanderlelie ◽  
James S M Cuffe ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Pregnant Women ◽  
Thyroid Function ◽  
Tertiary Care ◽  
Endocrine Disorders ◽  
Serum Selenium ◽  
Selenium Status ◽  
Increased Risk ◽  
The Relationship ◽  
Low Serum

Thyroid disorders are the most common endocrine disorders affecting women commencing pregnancy. Thyroid hormone metabolism is strongly influenced by selenium status; however, the relationship between serum selenium concentrations and thyroid hormones in euthyroid pregnant women is unknown. This study investigated the relationship between maternal selenium and thyroid hormone status during pregnancy by utilizing data from a retrospective, cross-sectional study (Maternal Outcomes and Nutrition Tool or MONT study) with cohorts from two tertiary care hospitals in South East Queensland, Australia. Pregnant women (n = 206) were recruited at 26–30 weeks gestation and serum selenium concentrations were assessed using inductively coupled plasma mass spectrometry. Thyroid function parameters were measured in serum samples from women with the lowest serum selenium concentrations (51.2 ± 1.2 µg/L), women with mean concentrations representative of the entire cohort (78.8 ± 0.4 µg/L) and women with optimal serum selenium concentrations (106.9 ± 2.3 µg/L). Women with low serum selenium concentrations demonstrated reduced fT3 levels (P < 0.05) and increased TPOAb (P < 0.01). Serum selenium was positively correlated with fT3 (P < 0.05) and negatively correlated with TPOAb (P < 0.001). Serum fT4 and thyroid-stimulating hormone (TSH) were not different between all groups, though the fT4/TSH ratio was increased in the low selenium cohort (P < 0.05). Incidence of pregnancy disorders, most notably gestational diabetes mellitus, was increased within the low serum selenium cohort (P < 0.01). These results suggest selenium status in pregnant women of South East Queensland may not be adequate, with possible implications for atypical thyroid function and undesirable pregnancy outcomes.

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