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Interaction Effects of Maternal Sexually Transmitted Infections with Prenatal Care Utilization Status on Preterm

Anthony J Kondracki1, Wei Li2, Zoran Bursac3

  • 1Department of Community Medicine, Mercer University School of Medicine, Macon, GA 31207, USA.

Journal of Clinical Medicine
|September 9, 2022
PubMed

Insights

Syphilis and inadequate prenatal care significantly increase preterm birth risk. Gonorrhea combined with insufficient prenatal care elevates low birthweight risk, highlighting the importance of STI screening during pregnancy.

Area of Science:

  • Reproductive Health
  • Epidemiology
  • Maternal-Fetal Medicine

Background:

  • Sexually transmitted infections (STIs) like chlamydia, gonorrhea, and syphilis are global health concerns.
  • Prenatal care (PNC) is crucial for monitoring maternal and fetal well-being during pregnancy.
  • The interplay between STIs and PNC utilization on adverse birth outcomes requires further investigation.

Purpose of the Study:

  • To investigate the interaction effects of common STIs (chlamydia, gonorrhea, syphilis) and prenatal care (PNC) utilization on preterm birth (PTB) and low birthweight (LBW).
  • To quantify the synergistic risks associated with specific STI and inadequate PNC combinations for PTB and LBW.

Main Methods:

  • A large-scale case-control study utilizing data from the 2019 United States National Vital Statistics System.
  • Inclusion of over 3.4 million singleton live births, with specific analysis for PTB (<37 weeks) and LBW (<2500 g) groups.
  • Application of interaction measures including Relative Excess Risk of Interaction (RERI), Attributable Proportion (AP), and Synergy Index (S) to assess combined effects.

Main Results:

  • Syphilis demonstrated a significant synergistic interaction with inadequate PNC, increasing PTB risk (RERI 2.12, AP 38%, SI 1.88).
  • Gonorrhea showed a significant synergistic interaction with inadequate PNC, increasing LBW risk (RERI 1.03, AP 28%, SI 1.64).
  • Chlamydia did not show significant interaction effects with PNC status on PTB or LBW in this cohort.

Conclusions:

  • Inadequate PNC amplifies the adverse effects of syphilis on preterm birth and gonorrhea on low birthweight.
  • Findings underscore the critical need for integrated STI screening and management within prenatal care programs.
  • This research contributes to understanding disease etiology and informs targeted public health interventions for improved birth outcomes.

Keywords:
interaction analysislow birthweightprenatal carepreterm birthsexually transmitted infections

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