TY - JOUR
T1 - Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-infected pregnant women and adverse infant outcomes
AU - Adachi, Kristina
AU - Klausner, Jeffrey D.
AU - Xu, Jiahong
AU - Ank, Bonnie
AU - Bristow, Claire C.
AU - Morgado, Mariza G.
AU - Watts, D. Heather
AU - Weir, Fred
AU - Persing, David
AU - Mofenson, Lynne M.
AU - Veloso, Valdilea G.
AU - Pilotto, Jose Henrique
AU - Joao, Esau
AU - Gray, Glenda
AU - Theron, Gerhard
AU - Santos, Breno
AU - Fonseca, Rosana
AU - Kreitchmann, Regis
AU - Pinto, Jorge
AU - Mussi-Pinhata, Marisa M.
AU - Ceriotto, Mariana
AU - Machado, Daisy Maria
AU - Bryson, Yvonne J.
AU - Grinsztejn, Beatriz
AU - Bastos, Francisco I.
AU - Siberry, George
AU - Nielsen-Saines, Karin
N1 - Publisher Copyright:
© 2016 Wolters Kluwer Health, Inc.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Background: Sexually transmitted infections (STIs) in pregnancy such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) may lead to adverse infant outcomes. Methods: Individual urine specimens from HIV-infected pregnant women diagnosed with HIV during labor were collected at the time of infant birth and tested by polymerase chain reaction for CT and NG. Infant HIV infection was determined at 3 months with morbidity/mortality assessed through 6 months. Results: Of 1373 maternal urine samples, 277 (20.2%) were positive for CT and/or NG; 249 (18.1%) for CT, 63 (4.6%) for NG and 35 (2.5%) for both CT and NG. HIV infection was diagnosed in 117 (8.5%) infants. Highest rates of adverse outcomes (sepsis, pneumonia, congenital syphilis, septic arthritis, conjunctivitis, low birth weight, preterm delivery and death) were noted in infants of women with CT and NG (23/35, 65.7%) compared with NG (16/28, 57.1%), CT (84/214, 39.3%) and no STI (405/1096, 37%, P = 0.001). Death (11.4% vs. 3%, P = 0.02), low birth weight (42.9% vs. 16.9%, P = 0.001) and preterm delivery (28.6% vs. 10.2%, P = 0.008) were higher among infants of CT and NG-coinfected women. Infants who had any adverse outcome and were born to women with CT and/or NG were 3.5 times more likely to be HIV infected after controlling for maternal syphilis (odds ratio: 3.5, 95% confidence interval: 1.4-8.3). By adjusted multivariate logistic regression, infants born to mothers with any CT and/or NG were 1.35 times more likely to have an adverse outcome (odds ratio, 1.35; 95% confidence interval, 1.03-1.76). Conclusions: STIs in HIV-infected pregnant women are associated with adverse outcomes in HIV-exposed infected and uninfected infants.
AB - Background: Sexually transmitted infections (STIs) in pregnancy such as Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) may lead to adverse infant outcomes. Methods: Individual urine specimens from HIV-infected pregnant women diagnosed with HIV during labor were collected at the time of infant birth and tested by polymerase chain reaction for CT and NG. Infant HIV infection was determined at 3 months with morbidity/mortality assessed through 6 months. Results: Of 1373 maternal urine samples, 277 (20.2%) were positive for CT and/or NG; 249 (18.1%) for CT, 63 (4.6%) for NG and 35 (2.5%) for both CT and NG. HIV infection was diagnosed in 117 (8.5%) infants. Highest rates of adverse outcomes (sepsis, pneumonia, congenital syphilis, septic arthritis, conjunctivitis, low birth weight, preterm delivery and death) were noted in infants of women with CT and NG (23/35, 65.7%) compared with NG (16/28, 57.1%), CT (84/214, 39.3%) and no STI (405/1096, 37%, P = 0.001). Death (11.4% vs. 3%, P = 0.02), low birth weight (42.9% vs. 16.9%, P = 0.001) and preterm delivery (28.6% vs. 10.2%, P = 0.008) were higher among infants of CT and NG-coinfected women. Infants who had any adverse outcome and were born to women with CT and/or NG were 3.5 times more likely to be HIV infected after controlling for maternal syphilis (odds ratio: 3.5, 95% confidence interval: 1.4-8.3). By adjusted multivariate logistic regression, infants born to mothers with any CT and/or NG were 1.35 times more likely to have an adverse outcome (odds ratio, 1.35; 95% confidence interval, 1.03-1.76). Conclusions: STIs in HIV-infected pregnant women are associated with adverse outcomes in HIV-exposed infected and uninfected infants.
KW - HIV
KW - adverse infant outcomes
KW - chlamydia
KW - gonorrhea
KW - pregnancy
KW - sexually transmitted infections
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U2 - 10.1097/INF.0000000000001199
DO - 10.1097/INF.0000000000001199
M3 - Article
C2 - 27164464
AN - SCOPUS:84966339695
SN - 0891-3668
VL - 35
SP - 894
EP - 900
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 8
ER -