妊娠期生殖器支原体(包括特定的合并感染)与出生体重降低有关:一项前瞻性队列研究。

IF 12.8 Q1 MEDICINE, RESEARCH & EXPERIMENTAL Med Pub Date : 2024-09-13 Epub Date: 2024-06-12 DOI:10.1016/j.medj.2024.05.007
Michelle J L Scoullar, Pele Melepia, Elizabeth Peach, Ruth Fidelis, Hadlee Supsup, Eliza M Davidson, Philippe Boeuf, Catriona S Bradshaw, Glenda Fehler, Priscah Hezeri, Dukduk Kabiu, Arthur Elijah, Peter M Siba, Elissa C Kennedy, Alexandra J Umbers, Leanne J Robinson, Andrew J Vallely, Steven G Badman, Lisa M Vallely, Freya J I Fowkes, Christopher J Morgan, William Pomat, Brendan S Crabb, James G Beeson
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引用次数: 0

摘要

背景:越来越多的报告显示,妊娠期生殖器支原体感染的频率与其他性传播感染(STI)相似。有关支原体感染对不良妊娠结局的影响的知识非常有限,尤其是相对于其他性传播感染或细菌性阴道病(BV)而言。生殖器疱疹是否会影响出生体重仍是一个未知数:方法:在巴布亚新几内亚的一项前瞻性队列研究中,研究人员对 416 对孕产妇和新生儿进行了调查,研究了出生体重与生殖器疱疹、其他性传播疾病(沙眼衣原体、淋病奈瑟菌和阴道毛滴虫)和妊娠期细菌性阴道病之间的关系:与未感染的妇女相比,在调整分析中,生殖器疱疹病毒(-166.9 g,95% 置信区间 [CI]:-324.2 至 -9.7 g,p = 0.038)和淋球菌(-274.7 g,95% 置信区间 [CI]:-561.9 至 12.5 g,p = 0.061)感染与出生体重较低有关。沙眼衣原体感染与出生体重降低的相关性不明显,阴道球菌和 BV 与出生体重降低无关。生殖器疱疹病毒(13.9%)、淋病双球菌(5.0%)和沙眼衣原体(20.0%)的性传播感染率很高;合并感染也很常见。同时感染生殖器疱疹病毒、淋病双球菌和/或沙眼衣原体对出生体重的影响更大:结论:M. 生殖器畸形是导致出生体重降低的潜在因素,合并感染似乎对出生体重有更大的负面影响。目前急需开展试验,研究早期诊断和治疗生殖器疱疹及其他孕期和孕前性传播疾病的影响:研究经费来自慈善机构、国家健康与医学研究委员会和伯纳特研究所。资助者在研究设计、数据收集和分析、发表决定或手稿撰写中均未参与。
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Mycoplasma genitalium in pregnancy, including specific co-infections, is associated with lower birthweight: A prospective cohort study.

Background: Mycoplasma genitalium infection in pregnancy is increasingly reported at similar frequencies to other sexually transmitted infections (STIs). Knowledge on its contribution to adverse pregnancy outcomes is very limited, especially relative to other STIs or bacterial vaginosis (BV). Whether M. genitalium influences birthweight remains unanswered.

Methods: Associations between birthweight and M. genitalium and other STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis) and BV in pregnancy were examined in 416 maternal-newborn pairs from a prospective cohort study in Papua New Guinea.

Findings: Compared to uninfected women, M. genitalium (-166.9 g, 95% confidence interval [CI]: -324.2 to -9.7 g, p = 0.038) and N. gonorrhoeae (-274.7 g, 95% CI: -561.9 to 12.5 g, p = 0.061) infections were associated with lower birthweight in an adjusted analysis. The association for C. trachomatis was less clear, and T. vaginalis and BV were not associated with lower birthweight. STI prevalence was high for M. genitalium (13.9%), N. gonorrhoeae (5.0%), and C. trachomatis (20.0%); co-infections were frequent. Larger effect sizes on birthweight occurred with co-infections of M. genitalium, N. gonorrhoeae, and/or C. trachomatis.

Conclusion: M. genitalium is a potential contributor to lower birthweight, and co-infections appear to have a greater negative impact on birthweight. Trials examining the impact of early diagnosis and treatment of M. genitalium and other STIs in pregnancy and preconception are urgently needed.

Funding: Funding was received from philanthropic grants, the National Health and Medical Research Council, and the Burnet Institute. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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Med
Med MEDICINE, RESEARCH & EXPERIMENTAL-
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102
期刊介绍: Med is a flagship medical journal published monthly by Cell Press, the global publisher of trusted and authoritative science journals including Cell, Cancer Cell, and Cell Reports Medicine. Our mission is to advance clinical research and practice by providing a communication forum for the publication of clinical trial results, innovative observations from longitudinal cohorts, and pioneering discoveries about disease mechanisms. The journal also encourages thought-leadership discussions among biomedical researchers, physicians, and other health scientists and stakeholders. Our goal is to improve health worldwide sustainably and ethically. Med publishes rigorously vetted original research and cutting-edge review and perspective articles on critical health issues globally and regionally. Our research section covers clinical case reports, first-in-human studies, large-scale clinical trials, population-based studies, as well as translational research work with the potential to change the course of medical research and improve clinical practice.
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