Adverse Birth Outcomes and Maternal Neisseria gonorrhoeae Infection: A Population-Based Cohort Study in Washington State.
Adverse Birth Outcomes and Maternal Neisseria gonorrhoeae Infection: A Population-Based Cohort Study in Washington State.
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DOI：
10.1097/olq.0000000000000592
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发表时间：
2017-05
影响因子：
3.1
通讯作者：
Hawes SE
中科院分区：
文献类型：
--
作者：
Heumann CL;Quilter LA;Eastment MC;Heffron R;Hawes SE
淋病奈瑟菌（淋病）仍然是生殖和产科并发症的一个重要原因。有有限的基于人群的研究来评估母体淋病与不良分娩结局之间的关系。对2003-2014年华盛顿州单胎妊娠妇女进行了一项基于人群的回顾性队列研究，使用相关的出生证明和出生住院出院数据。暴露队列包括怀孕期间诊断为淋病的妇女。未暴露组，定义为没有淋病的孕妇，根据出生年份的频率匹配，以4:1的比例选择。采用Logistic回归来确定母体淋病与不良分娩结局之间的粗比值比和校正比值比（OR）。与未患淋病的妇女（N=3276）相比，怀孕期间患有淋病的妇女（N=819）更可能是年轻、黑人、单身、受教育程度较低、多胎和吸烟者。经婚姻和吸烟状况调整后，母体淋病与低出生体重儿（LBW）的几率（调整OR为1.4,95%置信区间（CI）为1.0-1.8）相比无淋病妇女增加40%显著相关。与没有淋病的妇女相比，母体淋病与小于胎龄（SGA）婴儿的几率增加60%相关（OR 1.6, 95% CI 1.3-2.0）。该分析显示，患有淋病的孕妇更有可能生下LBW婴儿，这与先前的文献一致，并提供了母体淋病与SGA婴儿相关的新证据。这些发现支持加强公共卫生工作，以预防、识别和治疗妊娠期淋病感染。在华盛顿州的一项基于人群的队列研究中，母体淋病奈瑟菌感染与低出生体重婴儿和小于胎龄婴儿有关。
Neisseria gonorrhoeae (gonorrhea) remains an important cause of reproductive and obstetric complications. There has been limited population-based research to evaluate the association between maternal gonorrhea and adverse birth outcomes. A population-based retrospective cohort study was conducted of women with singleton pregnancies in Washington State from 2003–2014 using linked birth certificate and birth hospitalization discharge data. The exposed cohort consisted of women with gonorrhea diagnosed during pregnancy. The unexposed group, defined as pregnant women without gonorrhea, was selected by frequency-matching by birth year in a 4:1 ratio. Logistic regression was used to determine crude and adjusted odds ratios (OR) for the association of maternal gonorrhea and adverse birth outcomes. Women with gonorrhea during pregnancy (N=819) were more likely to be younger, Black, single, less educated, multiparous, and smokers compared to women without gonorrhea (N=3276). Maternal gonorrhea was significantly associated with a 40% increased odds (adjusted OR 1.4, 95% confidence interval (CI) 1.0–1.8) of low birth weight (LBW) infants compared to women without gonorrhea when adjusted for marital and smoking status. Maternal gonorrhea was associated with a 60% increased odds (OR 1.6, 95% CI 1.3–2.0) of small for gestational age (SGA) infants compared to women without gonorrhea. This analysis showed that pregnant women with gonorrhea were more likely to have LBW infants, consistent with prior literature, and provided new evidence that maternal gonorrhea is associated with SGA infants. These findings support increased public health efforts to prevent, identify, and treat gonorrhea infection during pregnancy. Maternal Neisseria gonorrhoeae infection was associated with low birth weight infants and small for gestational age infants in a population-based cohort study in Washington State.