Chlamydia trachomatis, Neisseria gonorrhoea, and Trichomonas vaginalis infections among pregnant women and male partners in Dutch midwifery practices: prevalence, risk factors, and perinatal outcomes

Abstract

Background Antenatal screening for HIV, syphilis and HBV has been successfully implemented in The Netherlands, but data on other STI among pregnant women or male partners are limited. Our objectives: (i) to assess the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among pregnant women and male partners, (ii) to identify risk factors for these STI during pregnancy, and (iii) to identify adverse perinatal outcomes (APO) associated with STI. Methods Cross-sectional study. Pregnant women aged ≤ 30 years (n = 548) and male partners (n = 425) were included at 30 midwifery practices during 2012–2016. Participants provided a self-collected vaginal swab (women) or urine sample (men) and completed a questionnaire. Perinatal data were derived from pregnancy cards. APO was defined as premature rupture of membranes, preterm delivery, low birthweight, stillbirth, neonatal conjunctival and respiratory infections. Data were analysed by logistic regression. Results STI were present in 2.4% of pregnant women (CT 1.8%, NG 0.4%, TV 0.4%), and in 2.2% of male partners (CT 2.2%, NG 0.2%, TV 0%). Of young women (≤ 20 years), 12.5% had a CT infection. Prevalent STI during pregnancy was associated with female young age (≤ 20 years vs ≥ 21 years) (adjusted OR 6.52, CI 95%: 1.11–38.33), male non-Western vs Western background (aOR 9.34, CI 2.34–37.21), and female with ≥ 2 sex partners < 12 months vs 0–1 (aOR 9.88, CI 2.08–46.91). APO was not associated with STI, but was associated with female low education (aOR 3.36, CI 1.12–10.09), complications with previous newborn (aOR 10.49, CI 3.21–34.25 vs no complications) and short duration (0–4 years) of relationship (aOR 2.75, CI 1.41–5.39 vs ≥ 5 years). Small-for-gestational-age was not associated with STI, but was associated with female low education (aOR 7.81, 2.01–30.27), female non-Western background (aOR 4.41, 1.74–11.17), and both parents smoking during pregnancy (aOR 2.94, 1.01–8.84 vs both non-smoking). Conclusions Prevalence of STI was low among pregnant women and male partners in midwifery practices, except for CT among young women. The study could not confirm previously observed associations between STI and APO, which is probably due to low prevalence of STI, small study sample, and presumed treatment for STI.

Establishment and application of a CRISPR-Cas12a-based RPA-LFS and fluorescence for the detection of Trichomonas vaginalis

“…Parasites & Vectors † Shan Li, Xiaocen Wang and Yanhui Yu contributed equally to this work *Correspondence: caolily1981@163.com; gongpt@jlu.edu.cn inflammatory disease and prostatitis [5], and can also cause perinatal complications, such as premature rupture of membranes [6] and preterm birth [7]. Meanwhile, T. vaginalis infection can increase the risk of HIV infection [8], cervical intraepithelial neoplasia [9] and posthysterectomy infection [10].…”

“…3c). With serial dilutions, a limit of one copy of pGEX-4T-1-actin could be detected with TV2-crRNA [10 copies and above: ANOVA, F (7,16) = 35.81, P < 0.0001, 1 copy: ANOVA, F (7,16) = 35.81, P = 0.0024] (Fig. 3b).…”

“…Trichomonas vaginalis (TV) belongs to a group of unicellular protozoan parasites that are mainly found in the vagina and urethra [ 1 ] and is the most common sexually transmitted infection (STI) [ 2 ] worldwide [ 3 , 4 ], with approximately 270 million [ 1 ] people infected each year. Trichomonas vaginalis infection causes inflammatory infections, such as vaginitis [ 3 ], urethritis, pelvic inflammatory disease and prostatitis [ 5 ], and can also cause perinatal complications, such as premature rupture of membranes [ 6 ] and preterm birth [ 7 ]. Meanwhile, T. vaginalis infection can increase the risk of HIV infection [ 8 ], cervical intraepithelial neoplasia [ 9 ] and posthysterectomy infection [ 10 ].…”

Sociodemographic Factors Associated With Gonorrhea and Chlamydia Infection in Pregnancy

“…Given that socially vulnerable populations who may have limited access to adequate health care carry high rates of sexually transmitted infections globally, efforts to identify risk factors and screening strategies for pregnant patients in low-income countries have emerged 18–20 . However, despite having overall lower infection rates, sociodemographic disparities are prevalent in middle- and high-income countries as well 21–23 . Our findings suggest sociodemographic factors, such as age, race/ethnicity, education, medical insurance, and access to prenatal care are associated with significant risks of gonorrhea and chlamydia in pregnancy, emphasizing the importance of considering these factors when screening pregnant patients.…”

Treatment of Chlamydial Infections

“…To prevent maternal complications and infant chlamydial infections, it is advised that pregnant women under 25 years old, pregnant women who have a new sex partner, a sex partner with multiple partners, or a sex partner with an STI, should be checked at the first antenatal control and retested in the third trimester. However, routine antenatal screening of pregnant women at risk for chlamydia disease cannot be utilized in all countries [31,77].…”