Sexually transmitted infections and risk of hypertensive disorders of pregnancy.
Sexually transmitted infections and risk of hypertensive disorders of pregnancy.
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DOI：
10.1038/s41598-022-17989-0
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发表时间：
2022-08-16
影响因子：
4.6
通讯作者：
Comeaux, Camillia R.
中科院分区：
文献类型：
--
作者：
Taylor, Brandie DePaoli;Hill, Ashley, V;Perez-Patron, Maria J.;Haggerty, Catherine L.;Schisterman, Enrique F.;Naimi, Ashley, I;Noah, Akaninyene;Comeaux, Camillia R.
妊娠期高血压疾病(HDP)导致孕产妇发病率和死亡率，但很少在围产期性传播感染研究中进行检查。我们调查了38,026名单身孕妇中常见的性传播感染和HDP之间的关系。对数二项回归计算了妊娠期高血压、重度子痫前期、轻度子痫前期和叠加子痫前期的相对危险度(RR)和95%可信区间(CI)。所有模型都根据保险类型、产妇年龄、种族/民族和教育进行了调整。其他调整导致了类似的影响估计。衣原体感染与子痫前期有关，具有严重的特征(RRadj.1.4，95%可信区间1.1，1.9)。当我们只检查第一次产前检查诊断(RRadj.1.3，95%可信区间0.9，1.9)和持续或复发感染(RRadj.2.0，95%可信区间1.1，3.4)。对于衣原体(RRadj.)2.0，95%可信区间1.3，2.9)和淋病(RRadj.3.0，95%CI 1.1，12.2)，未记录治疗的妇女更有可能患上有严重症状的先兆子痫。在不同的围产期人群中，性传播感染可能与具有严重特征的先兆子痫有关。随着性传播感染率的惊人增长，有必要重新审视孕妇的负担，并确定感染与妊娠高血压疾病之间是否存在联系。
Hypertensive disorders of pregnancy (HDP) result in maternal morbidity and mortality but are rarely examined in perinatal studies of sexually transmitted infections. We examined associations between common sexually transmitted infections and HDP among 38,026 singleton pregnancies. Log-binomial regression calculated relative risk (RRs) and 95% confidence intervals (CIs) for associations with gestational hypertension, preeclampsia with severe features, mild preeclampsia, and superimposed preeclampsia. All models were adjusted for insurance type, maternal age, race/ethnicity, and education. Additional adjustments resulted in similar effect estimates. Chlamydia was associated with preeclampsia with severe features (RRadj. 1.4, 95% CI 1.1, 1.9). Effect estimates differed when we examined first prenatal visit diagnosis only (RRadj. 1.3, 95% CI 0.9, 1.9) and persistent or recurrent infection (RRadj. 2.0, 95% CI 1.1, 3.4). For chlamydia (RRadj. 2.0, 95% CI 1.3, 2.9) and gonorrhea (RRadj. 3.0, 95% CI 1.1, 12.2), women without a documented treatment were more likely to have preeclampsia with severe features. Among a diverse perinatal population, sexually transmitted infections may be associated with preeclampsia with severe features. With the striking increasing rates of sexually transmitted infections, there is a need to revisit the burden in pregnant women and determine if there is a link between infections and hypertensive disorders of pregnancy.
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