Sexually transmitted infections and risk of hypertensive disorders of pregnancy

• Type of Material: Article
• Authors: Brandie DePaoli Taylor, UT Medical Branch at Galveston; Ashley V Hill, University of Pittsburgh Graduate School of Public Health; Maria J Perez-Patron, Texas A&M University, College Station; Catherine L Haggerty, University of Pittsburgh Graduate School of Public Health; Enrique F Schisterman, University of Pennsylvania Perelman School of Medicine; Akaninyene Noah, UT Medical Branch at Galveston; Ashley Naimi, Emory University; CR Comeaux, UT Medical Branch at Galveston
• Language: English
• Date: 2022-12-01
• Publisher: Springer Nature Limited
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1038/s41598-022-17989-0
• Title of Journal or Parent Work: Scientific Reports
• Volume: 12
• Issue: 1
• Start Page: 13904
• End Page: 13904
• Grant/Funding Information: This work was funded in part by NIH/NIAID R01AI143653 to B.D.T.
• Keywords: Gonorrhea; Pregnancy; Pre-Eclampsia; Sexually Transmitted Diseases; Hypertension, Pregnancy-Induced; Female; Prenatal Care; Humans
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Obstetrics and Gynecology; Biology, Biostatistics

Abstract

Hypertensive disorders of pregnancy (HDP) result in maternal morbidity and mortality but are rarely examined in perinatal studies of sexually transmitted infections. We examined associations between common sexually transmitted infections and HDP among 38,026 singleton pregnancies. Log-binomial regression calculated relative risk (RRs) and 95% confidence intervals (CIs) for associations with gestational hypertension, preeclampsia with severe features, mild preeclampsia, and superimposed preeclampsia. All models were adjusted for insurance type, maternal age, race/ethnicity, and education. Additional adjustments resulted in similar effect estimates. Chlamydia was associated with preeclampsia with severe features (RRadj. 1.4, 95% CI 1.1, 1.9). Effect estimates differed when we examined first prenatal visit diagnosis only (RRadj. 1.3, 95% CI 0.9, 1.9) and persistent or recurrent infection (RRadj. 2.0, 95% CI 1.1, 3.4). For chlamydia (RRadj. 2.0, 95% CI 1.3, 2.9) and gonorrhea (RRadj. 3.0, 95% CI 1.1, 12.2), women without a documented treatment were more likely to have preeclampsia with severe features. Among a diverse perinatal population, sexually transmitted infections may be associated with preeclampsia with severe features. With the striking increasing rates of sexually transmitted infections, there is a need to revisit the burden in pregnant women and determine if there is a link between infections and hypertensive disorders of pregnancy.