Exploring Pregnancy Outcomes Associated with SARS-CoV-2 Infection

Background and Objectives: The ongoing pandemic proved to be a tremendous challenge to all economic layers, healthcare, and people safety. As more than one year elapsed since the beginning of the COVID-19 pandemic, a multitude of medical studies involving the SARS-CoV-2 virus helped researchers and medical practitioners in understanding the effects it has on all sorts of patients until effective vaccines were finally developed and distributed for mass vaccination. Still, the SARS-CoV-2 and its new variants remain a potential threat towards all categories of patients, including a more delicate group represented by pregnant women. Thus, the current study aims to investigate the potential effects on obstetrical outcomes after a positive SARS-CoV-2 infection. Materials and Methods: This single-center prospective cohort study investigated the pregnancy outcomes in a total of 1039 eligible pregnant women between 30 August 2020 and 30 January 2021. Multiple patient characteristics and obstetrical outcomes were tested and analyzed in a multivariate regression model to establish potential risks determined by a COVID-19-positive pregnancy towards the mother and the newborn. Results: In the study sample, there were 938 pregnancies included without COVID-19 and 101 pregnant women identified with a positive COVID-19 infection. COVID-19 was significantly associated with a 2-fold increase in the risk of premature rupture of membranes and 1.5 times higher risk of preterm birth with emergency c-sections and lower APGAR scores. Also, significantly more newborns were given birth prematurely, with lower APGAR scores after the mothers were infected with SARS-CoV-2. Conclusions: A third-trimester infection with SARS-CoV-2 is a significant risk factor for preterm birth via an emergency cesarean section, a premature rupture of membranes, and a lower APGAR score in newborns, as compared with pregnancies where COVID-19 was not identified.

Download Full-text

Factores de riesgo asociados al parto pre término en el hospital nacional Guillermo Almenara Irigoyen de enero a junio del 2010.

Revista ECIPeru ◽

10.33017/reveciperu2011.0036/ ◽

2019 ◽

pp. 143-149

Keyword(s):

Risk Factors ◽

Preterm Birth ◽

Pregnant Women ◽

Preterm Delivery ◽

Multiple Pregnancy ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

National Hospital ◽

Factors Associated ◽

Factores De Riesgo

Factores de riesgo asociados al parto pre término en el hospital nacional Guillermo Almenara Irigoyen de enero a junio del 2010. Risk factors associated with preterm delivery in the Guillermo Almenara Irigoyen National Hospital from January to June 2010 Lizbeth Estefanía Díaz Polo Universidad de San Martin de Porres. Lima 12 DOI: https://doi.org/10.33017/RevECIPeru2011.0036/ RESUMEN El parto pre término ocurre entre las 22 y antes de las 37 semanas. Su etiología es multifactorial y es causa principal de morbilidad y mortalidad perinatal. El objetivo fue determinar los factores de riesgo asociados al parto pre término en gestantes del Hospital Nacional Guillermo Almenara Irigoyen de Enero a Junio del 2010. Se realizó un estudio retrospectivo, caso - control y descriptivo. Las historias clínicas de pacientes casos y controles, fueron revisadas y registradas en fichas y se procesaron con el SPSS versión 15. Los resultados fueron 81 pacientes con diagnóstico de parto pre término, con significancia estadística en las siguientes variables: ausencia de atención prenatal (OR 3.07, P>0.05), pre eclampsia (OR 20.86, P>0.001), ruptura prematura de membranas (OR 4.03, P>0.005), embarazo múltiple (OR 5.64, P>0.01), corioamnionitis (OR 2.02, P>0.1), lugar de nacimiento: sierra (OR 3.88, P>0.05) y nivel socioeconómico D-E (OR12.73, P>0.05). Se evidencio que gestantes más pobres y con menor nivel educativo presentan mayor incidencia de parto pre término [1] [2] [3]. Que el 21% de los partos pre término, estuvo asociado a la ruptura prematura de membranas (OR 4.03) dato que se encuentra dentro del rango de incidencia, ya que Aagaard-Tillery [4] (2005) señala una incidencia de la ruptura prematura de membrana pre término entre 30 y 40% y Fabián (2008) observó 11.67% de ruptura prematura de membranas [5]. Las gestantes con pre eclampsia tuvieron un riesgo 20 veces más de presentar parto pre término. El 34.6% con parto pre término presentó pre eclampsia, de ellas el 42.8% fue pre eclampsia severa, 25% leve y 32.14% síndrome de HELLP; dato similar al observado por Salviz en su estudio en el Hospital Cayetano Heredia, donde encontró un 30 % de parto pre término en pacientes con pre eclampsia; si bien es conocido que la pre eclampsia afecta del 3 al 5% de las gestaciones, no existen estudios sobre la incidencia de la pre eclampsia en el parto pre término [6]. Se concluye que el principal factor de riesgo asociado al parto pre término fue la pre eclampsia. Haber nacido en la sierra, pertenecer a nivel socioeconómico D-E, ausencia de atención prenatal, ruptura prematura de membranas, coriomanionitis y embarazo múltiple fueron también significativos. Descriptores: factores de riesgo, parto pre término, parto a término, pre eclampsia. ABSTRACT Preterm birth occurs between 22 and before 37 weeks. Its etiology is multifactorial and is a major cause of perinatal morbidity and mortality. The objective was to determine the risk factors associated with preterm delivery in pregnant women Guillermo Almenara Irigoyen National Hospital from January to June 2010. We performed a retrospective case - control and descriptive. The case histories of patients and controls were reviewed and recorded in chips and processed with SPSS version 15. The results were 81 patients diagnosed with preterm birth, with statistical significance in the following variables: absence of prenatal care (OR 3.07, P> 0.05), pre-eclampsia (OR 20.86, P <0.001), premature rupture of membranes (OR 4.03, P> 0,005), multiple pregnancy (OR 5.64, P> 0.01), chorioamnionitis (OR 2.02, P> 0.1), place of birth: saw (OR 3.88, P> 0.05) and socioeconomic status (OR12.73, P> 0.05). It was evident that more poor pregnant women with less education have a higher incidence of preterm delivery [1] [2] [3]. That 21% of preterm births was associated with premature rupture of membranes (OR 4.03) data that is within the range of incidence, as Aagaard-Tillery [4] (2005) noted an incidence of premature rupture preterm membrane between 30 and 40% and Fabian (2008) observed 11.67% of premature rupture of membranes [5]. Pregnant women with preeclampsia had a 20 times higher risk of preterm birth present. 34.6% presented with preterm birth pre-eclampsia, of which 42.8% was severe preeclampsia, 25% and 32.14% mild HELLP syndrome; data Salviz similar to that observed in their study in the Cayetano Heredia Hospital, where he found a 30 % of preterm birth in patients with preeclampsia, although it is known that pre-eclampsia affects 3 to 5% of pregnancies, no studies on the incidence of preeclampsia in preterm labor [6]. We conclude that the main risk factor associated with preterm delivery was preeclampsia. Being born in the mountains, belong to socioeconomic status, lack of prenatal care, premature rupture of membranes, coriomanionitis and multiple pregnancy were also significant. Keywords: risk factors, preterm delivery, term delivery, pre-eclampsia.

Download Full-text

Analysis of Pregnancy Characteristics and Perinatal Outcome of Mediastinal Uterus in China

Iranian Journal of Public Health ◽

10.18502/ijph.v50i12.7938 ◽

2021 ◽

Author(s):

Na Zhang ◽

Ying Wang ◽

Li Zhang ◽

Chanyun Xiao

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Postpartum Hemorrhage ◽

Mode Of Delivery ◽

Premature Delivery ◽

Targeted Prevention ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Neonatal Asphyxia ◽

Fetal Position

Background: To analyze the complications and outcome of mediastinal uterine pregnancy, and put forward targeted prevention and treatment measures. Methods: A total of 248 pregnant women with mediastinal uterus treated were enrolled from Jan 2015 to Dec 2018 in the Maternal and Child Health Hospital of Hubei Province, China. The data, including complications of pregnancy, gestational weeks, mode of delivery, postpartum hemorrhage, placental condition and perinatal prognosis, were collected and analyzed. Results: There were 12 cases with abnormal fetal position in the previous cesarean section. The total number of cases with abnormal fetal position was 99(49.75%). For women with abnormal fetal position during mediastinal uterine pregnancy, there was a significant increase in the incidence of placental abruption (P<0.05). The average gestational age at termination of pregnancy was 37+5weeks. There were 55 cases (22.18%) of premature and 49 cases (19.75%) of premature rupture of membranes, including 29 cases of abnormal fetal position and premature rupture of membranes, mediastinal uterus preterm birth, premature rupture of membranes (P<0.05). There were 13 cases (5.24%) of postpartum hemorrhage, natural birth without neonatal asphyxia, five cases (2.02%) of neonatal asphyxia, preterm birth, and 51 cases (20.56%) of placental adhesion. Of these, 37 cases were cesarean, 13 were spontaneous production, and 71 were fetal umbilical cord winding. Conclusion: The pregnancy induced spontaneous abortion, premature delivery, premature rupture of membranes and abnormal fetal position in mediastinal uterus are significantly higher than normal pregnancy. The complications during delivery are significantly higher than in normal pregnant women.

Download Full-text

Management of born too soon preterm birth complicated by preterm premature rupture of membranes

HEALTH OF WOMAN ◽

10.15574/hw.2016.111.58 ◽

2016 ◽

pp. 58-64

Author(s):

O.B. Malanchuk ◽

◽

V.P. Lakatosh ◽

O.U. Kostenko ◽

M.I. Antonuk ◽

...

Keyword(s):

Preterm Birth ◽

Statistical Analysis ◽

Pregnant Women ◽

Neonatal Mortality ◽

Perinatal Complications ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Mortality And Morbidity ◽

Pregnancy And Childbirth ◽

Preterm Premature Rupture

In Ukraine, each year born about 1,000 children ELBW, representing 0.3% of all newborns. The survival of infants with ELBW in our country has a slow upward trend and does not exceed 50%. Infants with ELBW have the highest risk of death and are the group most at risk for the development of chronic diseases of the respiratory and nervous systems and sensory apparatus and associated disability. Considering the growth of the number of children at private ELBW on the background PPROM, high perinatal morbidity and infant mortality, reduced health and reproductive capacity of women becoming urgency tactics of pregnancy and labor with premature rupture of membranes. The objective: perynatalniyh reduce complications in terms of 22-28 weeks of pregnancy complicated by premature rupture of membranes based on developing the tactics of pregnancy and childbirth. Patients and methods. To reduce perinatal complications analyzed the effect of different methods of pregnancy and childbirth on the state of newborns in gestational age 22-28 weeks against the backdrop of premature discharge of amniotic fluid. The control group consisted of 56 women who had less than a day anhydrous term. In the study group applied expectant tactics of anhydrous long term. Depending on the length of the term of anhydrous main group was divided into 2 subgroups. Sub-IA amounted to 86 pregnant women with anhydrous period of 5 days, and IP subgroup totaled 64 pregnant women with anhydrous period of 25 days. Statistical analysis of the results was performed using Microsoft Excel. Probability difference calculated by Student’s t-criterion. Results. Аnalyzing the structure and frequency of obstetric and perinatal complications in women in the period 22-28 weeks of pregnancy with different duration waterless terms, different terms of delivery proved the effectiveness of the tactics of delivery, which is used in perinatal centers m. Kyiv. This correlates with clinical data - statistical analysis of indicators of neonatal mortality and morbidity. Conclusion. Оf the research found that the rates of neonatal mortality and morbidity affecting: duration of anhydrous interval, gestational period, methods of delivery. Long expectant tactics leads to a real reduction of RDS, but an increase in the incidence of chorioamnionitis and neonatal infection. Therefore, wait-recommended tactics for 5 days, followed by delivery of women. At 22-27 weeks of pregnancy delivery path has no impact on rates of neonatal morbidity. The advantage in the delivery of women in the period 27-28 weeks, especially in the immature cervix and pelvic peredlezhenni fetal provided cesarean section. Key words: born too soon preterm birth, preterm premature rupture of membranes, pregnancy, method of delivery, birth with extremely low body weight.

Download Full-text

Association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes: a cohort study

BMJ Open ◽

10.1136/bmjopen-2020-047900 ◽

2021 ◽

Vol 11 (2) ◽

pp. e047900

Author(s):

Min Du ◽

Jie Yang ◽

Na Han ◽

Min Liu ◽

Jue Liu

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Time Trends ◽

Foetal Distress ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Gestational Weight ◽

Excessive Gestational Weight Gain ◽

Adverse Pregnancy ◽

Beijing China

ObjectivesThe secondary impacts of the COVID-19 pandemic on adverse maternal and neonatal outcomes remain unclear. In this study, we aimed to evaluate the association between the COVID-19 pandemic and the risk for adverse pregnancy outcomes.DesignWe conduced retrospective analyses on two cohorts comprising 7699 pregnant women in Beijing, China, and compared pregnancy outcomes between the pre-COVID-2019 cohort (women who delivered from 20 May 2019 to 30 November 2019) and the COVID-2019 cohort (women who delivered from 20 January 2020 to 31 July 2020). The secondary impacts of the COVID-2019 pandemic on pregnancy outcomes were assessed by using multivariate log-binomial regression models, and we used interrupted time-series (ITS) regression analysis to further control the effects of time-trends.SettingOne tertiary-level centre in Beijing, ChinaParticipants7699 pregnant women.ResultsCompared with women in the pre-COVID-19 pandemic group, pregnant women during the COVID-2019 pandemic were more likely to be of advanced age, exhibit insufficient or excessive gestational weight gain and show a family history of chronic disease (all p<0.05). After controlling for other confounding factors, the risk of premature rupture of membranes and foetal distress was increased by 11% (95% CI, 1.04 to 1.18; p<0.01) and 14% (95% CI, 1.01 to 1.29; p<0.05), respectively, during the COVID-2019 pandemic. The association still remained in the ITS analysis after additionally controlling for time-trends (all p<0.01). We uncovered no other associations between the COVID-19 pandemic and other pregnancy outcomes (p>0.05).ConclusionsDuring the COVID-19 pandemic, more women manifested either insufficient or excessive gestational weight gain; and the risk of premature rupture of membranes and foetal distress was also higher during the pandemic.

Download Full-text

Evaluation of perinatal outcomes in pregnant women with preterm premature rupture of membranes

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.03.269 ◽

2016 ◽

Vol 62 (3) ◽

pp. 269-275 ◽

Cited By ~ 9

Author(s):

Alex Sandro Rolland Souza ◽

Adriane Farias Patriota ◽

Gláucia Virgínia de Queiroz Lins Guerra ◽

Brena Carvalho Pinto de Melo

Keyword(s):

Amniotic Fluid ◽

Pregnant Women ◽

Gestational Age ◽

Perinatal Outcomes ◽

Perinatal Complications ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Amniotic Fluid Index ◽

Apgar Scores ◽

Preterm Premature Rupture

SUMMARY Objective: To determine the association between amniotic fluid index (AFI) and perinatal outcomes in preterm premature rupture of membranes (PPROM). Method: A retrospective cohort study was conducted between 2008 and 2012. 86 pregnant women were included, with a diagnosis of PPROM and gestational age from 24 to 35 weeks. Women who presented hypertensive disorders, diabetes, fetuses with birth defects and infection at admission were excluded. To determine the association between AFI and perinatal outcomes, chi-square and Fisher’s exact test were used if necessary, as well as risk ratio (RR) and 95% confidence intervals (95CI). Correlation between AFI and perinatal outcomes was determined by using simple linear regression, and AFI progression during pregnancy was analyzed by Z-test. Results: When comparing newborns presenting ultrasound with AFI<5cm and AFI>5cm, there was a higher frequency of perinatal mortality when the AFI was lower than 5 cm. However, when the oligohydramnios was diagnosed as severe (AFI<3cm), there was a higher frequency of Apgar scores less than seven at 1 minute, neonatal sepsis and early neonatal mortality compared to those presenting AFI>3cm. There was a positive correlation between AFI and gestational age at delivery, birth weight and Apgar scores at minutes 1 and 5. There was also a decrease in amniotic fluid volume with increased gestational age. Conclusion: The presence of severe oligohydramnios after PPROM contributed to a higher frequency of perinatal complications and death.

Download Full-text

A Comparative Study on Adverse Pregnancy Outcomes in Pregnant Women with Different Age

Journal of Holistic Nursing and Midwifery ◽

10.32598/jhnm.31.1.2017 ◽

2021 ◽

Vol 31 (1) ◽

pp. 9-16

Author(s):

Soudabe Ebrahimi ◽

◽

Maryam Niknami ◽

Fateme Rafat ◽

Ehsan Kazemnezhad Leili ◽

...

Keyword(s):

Pregnant Women ◽

Pregnancy Outcomes ◽

Maternal Age ◽

Age Groups ◽

Maternal Diabetes ◽

Neonatal Outcomes ◽

Age Group ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Adverse Pregnancy

Introduction: Delayed childbearing is increasing. Increased maternal age has been associated with increased risk of pregnancy complications. On the other hand, the adolescent pregnancy has traditionally been considered high-risk, especially in developing countries. Objective: This study aimed to compare the adverse pregnancy outcomes in different age groups of pregnant women. Materials and Methods: The analytical study with cross-sectional design was conducted on 345 pregnant women referred to one of the maternity hospitals in Rasht, Iran in 2018 who were selected by sequential sampling method. They were followed from gestational age >37 weeks until delivery in 3 groups: <19 years, 19-35 years and >35 years. The data collection tool was a two-part researcher-made questionnaire which surveys demographic, fertility, and socioeconomic information and adverse maternal and neonatal outcomes. The collected data were analyzed using descriptive and inferential statistics (Chi-square test, Fisher’s exact test, Kruskal-Wallis test, ANOVA, Bonfrroni test, Spearman correlation test, and multiple linear regression analysis). Results: The highest prevalence of maternal diabetes mellitus (29.7%) and cesarean section (72.46%) were reported in the age group >35 years. The highest frequency of premature rupture of membranes (18.8%) and abnormal fetal presentation (13.8 %) were reported in age groups <19 years and 19-35 years, respectively. Among maternal outcomes, maternal diabetes, abnormal fetal presentation, premature rupture of membranes and delivery by cesarean section were significantly different between three groups (P<0.05). There was a significant difference between maternal age and neonatal outcomes in ages groups <19 years and 19-35 years (P<0.05). Multiple linear regression model showed that the maternal age <19 years was a predictor of adverse neonatal outcomes. The group <19 years reported more adverse outcomes than the age group 19-35 years (β=0.282, 95% CL: 0.002-0.561, P=0.049). Conclusion: All age groups of pregnant women faced some pregnancy outcomes. Due to Iran’s new plan to encourage childbearing, prenatal screening, and receiving more prenatal care, we recommend pregnant women to participate in childbirth preparation training courses.

Download Full-text

Morphological and electron-microscopic features of the investigated placente in very early previous delivery, complicated premature rupture of membranes

Reproductive health of woman ◽

10.30841/2708-8731.1.2021.229716 ◽

2021 ◽

Vol 1 ◽

pp. 54-60

Author(s):

O.B. Malanchuk ◽

I.V. Poladich ◽

O.Yu. Kostenko ◽

S.O. Avramenko

Keyword(s):

Preterm Birth ◽

Pregnant Women ◽

Gestational Age ◽

Progesterone Receptors ◽

Study Groups ◽

Main Group ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Electron Microscopic ◽

Microscopic Features

The article presents modern phenomena about morphological and electron microscopic features of the studied placentas in very early premature birth, complicated by premature rupture of membranes. These features were studied in different tactics of data management of pregnant women. The objective: study of morphological and electron microscopic features of the studied placentas in very early preterm birth, complicated by PRPO.Materials and methods. All 206 patients were divided into two groups. The main group included 150 pregnant women with PRPO at a gestational age of 22–28 weeks, and the control group included 56 pregnant women with a physiological course of gestation at a period of 22–28 weeks. The main group is divided into 2 groups depending on the duration of waiting tactics and the method of delivery. Group I patients received treatment in accordance with clinical protocols by orders of the Ministry of Health of Ukraine. Pregnant women of group II were offered a tactic that involves prolonging gestation for 5 days (antibiotic therapy, RDS prophylaxis, magnesium therapy, in the presence of streptococcus B – treatment) followed by delivery by cesarean section. All patients with PRPO received antibacterial therapy from the day of hospitalization. Results. The results of the study indicate that no significant differences between the study groups during the study were found. The expression data of progesterone receptors correspond to the results of hormonal research, which also did not reveal significant changes in the study groups, and confirm the theory of finding new provoking factors of PRPO in preterm birth. Conclusions. Thus, it was first demonstrated that the content of progesterone in blood plasma and immunohistochemical expression of progesterone receptors in the placenta on the background of DRPP depends on the gestational age and not on the duration of the anhydrous period.

Download Full-text

Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019) – Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and the Management of Preterm Premature Rupture of Membranes

Geburtshilfe und Frauenheilkunde ◽

10.1055/a-0903-2735 ◽

2019 ◽

Vol 79 (08) ◽

pp. 813-833 ◽

Cited By ~ 2

Author(s):

Richard Berger ◽

Harald Abele ◽

Franz Bahlmann ◽

Ivonne Bedei ◽

Klaus Doubek ◽

...

Keyword(s):

Preterm Birth ◽

German Society ◽

Consensus Conference ◽

Tertiary Prevention ◽

Short Version ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Preterm Premature Rupture ◽

Gynecology And Obstetrics ◽

Self Help Groups

Abstract Aims This is an official guideline of the German Society for Gynecology and Obstetrics (DGGG), the Austrian Society for Gynecology and Obstetrics (ÖGGG) and the Swiss Society for Gynecology and Obstetrics (SGGG). The aim of this guideline is to improve the prediction, prevention and management of preterm birth based on evidence obtained from recently published scientific literature, the experience of the members of the guideline commission and the views of self-help groups. Methods The members of the participating medical societies and organizations developed Recommendations and Statements based on the international literature. The Recommendations and Statements were adopted following a formal consensus process (structured consensus conference with neutral moderation, voting done in writing using the Delphi method to achieve consensus). Recommendations Part 2 of this short version of the guideline presents Statements and Recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes.

Download Full-text

Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae: systematic review and meta-analysis

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054653 ◽

2021 ◽

Vol 97 (2) ◽

pp. 104-111

Author(s):

Lisa M Vallely ◽

Dianne Egli-Gany ◽

Handan Wand ◽

William S Pomat ◽

Caroline S E Homer ◽

...

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Low Birth Weight ◽

Perinatal Mortality ◽

Low Income ◽

Premature Rupture Of Membranes ◽

Premature Rupture ◽

Middle Income ◽

Middle Income Countries ◽

Adverse Pregnancy

Objective To examine associations between Neisseria gonorrhoeae (NG) infection during pregnancy and the risk of preterm birth, spontaneous abortion, premature rupture of membranes, perinatal mortality, low birth weight and ophthalmia neonatorum. Data sources We searched Medline, EMBASE, the Cochrane Library and Cumulative Index to Nursing and Allied Health Literature for studies published between 1948 and 14 January 2020. Methods Studies were included if they reported testing for NG during pregnancy and compared pregnancy, perinatal and/or neonatal outcomes between women with and without NG. Two reviewers independently assessed papers for inclusion and extracted data. Risk of bias was assessed using established checklists for each study design. Summary ORs with 95% CIs were generated using random effects models for both crude and, where available, adjusted associations. Results We identified 2593 records and included 30 in meta-analyses. Women with NG were more likely to experience preterm birth (OR 1.55, 95% CI 1.21 to 1.99, n=18 studies); premature rupture of membranes (OR 1.41, 95% CI 1.02 to 1.92, n=9); perinatal mortality (OR 2.16, 95% CI 1.35 to 3.46, n=9); low birth weight (OR 1.66, 95% CI 1.12 to 2.48, n=8) and ophthalmia neonatorum (OR 4.21, 95% CI 1.36 to 13.04, n=6). Summary adjusted ORs were, for preterm birth 1.90 (95% CI 1.14 to 3.19, n=5) and for low birth weight 1.48 (95% CI 0.79 to 2.77, n=4). In studies with a multivariable analysis, age was the variable most commonly adjusted for. NG was more strongly associated with preterm birth in low-income and middle-income countries (OR 2.21, 95% CI 1.40 to 3.48, n=7) than in high-income countries (OR 1.38, 95% CI 1.04 to 1.83, n=11). Conclusions NG is associated with a number of adverse pregnancy and newborn outcomes. Further research should be done to determine the role of NG in different perinatal mortality outcomes because interventions that reduce mortality will have the greatest impact on reducing the burden of disease in low-income and middle-income countries. PROSPERO registration number CRD42016050962.

Download Full-text