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

Vallely, Lisa M; Egli-Gany, Dianne; Wand, Handan; Pomat, William S; Homer, Caroline S E; Guy, Rebecca; Silver, Bronwyn; Rumbold, Alice R; Kaldor, John M; Vallely, Andrew J; Low, Nicola (2021). Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae: systematic review and meta-analysis. Sexually transmitted infections, 97(2), pp. 104-111. BMJ Publishing Group 10.1136/sextrans-2020-054653

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Egli, Dianne and Low, Nicola

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1368-4973

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

05 Feb 2021 19:32

Last Modified:

20 Feb 2021 01:35

Publisher DOI:

10.1136/sextrans-2020-054653

PubMed ID:

33436505

Uncontrolled Keywords:

Neisseria gonorrhoeae meta-analysis pregnancy premature birth systematic review

BORIS DOI:

10.48350/151991

URI:

https://boris.unibe.ch/id/eprint/151991

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