Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/129961
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Type: Journal article
Title: Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae: systematic review and meta-analysis
Author: Vallely, L.M.
Egli-Gany, D.
Wand, H.
Pomat, W.S.
Homer, C.S.E.
Guy, R.
Silver, B.
Rumbold, A.R.
Kaldor, J.M.
Vallely, A.J.
Low, N.
Citation: Sexually Transmitted Infections, 2021; 97(2):104-111
Publisher: BMJ Publishing Group
Issue Date: 2021
ISSN: 1368-4973
1472-3263
Statement of
Responsibility: 
Lisa M Vallely, Dianne Egli-Gany, Handan Wand, William S Pomat, Caroline S E Homer, Rebecca Guy ... et al.
Abstract: 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. 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. 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. 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). 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. CRD42016050962.
Keywords: Neisseria gonorrhoeae; meta-analysis; pregnancy; premature birth; systematic review
Rights: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
RMID: 1000033065
DOI: 10.1136/sextrans-2020-054653
Appears in Collections:Medicine publications

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