Search

Background Sexually transmitted infections (STIs) have recently been linked to hypertensive disorders of pregnancy (HDP). However, the impact of Neisseria gonorrhoeae on risk of HDP is not well understood. This study determined the impact of gonorrhea and gonorrhea coinfection on HDP and other adverse pregnancy outcomes in a population with a high screening rate and presumed treatment. Methods This retrospective study included 29 821 singleton births between 2016 and 2021. The STI testing results, demographic variables, and pregnancy outcomes were identified from electronic health records. The HDP were primary outcomes of interest including gestational hypertension, preeclampsia, and superimposed preeclampsia. We further examined preeclampsia subtypes defined by severe features and gestational age of delivery (term and preterm preeclampsia). Secondary outcomes included preterm premature rupture of membranes, chorioamnionitis, and preterm delivery. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Models were adjusted for maternal age, maternal race/ethnicity, and smoking. Results Gonorrhea screening occurred in 95% of the population. Gonorrhea increased the odds of preterm preeclampsia (adjusted OR [ORadj.], 1.95; 95% CI, 1.02–3.73) and preterm birth (ORadj. 1.78; 95% CI, 1.22–2.60). Furthermore, gonorrhea-chlamydia coinfection was associated with preterm birth (ORadj. 1.77; 95% CI, 1.03–3.04). However, results were similar when we examined gonorrhea monoinfection (ORadj. 1.76; 95% CI, 1.04–2.97). Conclusions Among a diverse population of pregnant individuals, gonorrhea increased odds of preterm preeclampsia and preterm delivery Further research is needed to determine the burden of STIs on HDP, including investigations into biological effects during pregnancy. [ABSTRACT FROM AUTHOR]

Problem: Interferon epsilon (IFNε) is a unique type I IFN that is expressed in response to sex steroids. Studies suggest that type I IFNs regulate inflammation‐induced preterm birth (PTB), but no study has examined the role of IFNε in human pregnancy. Method of Study: We used stored vaginal swabs between 8 and 26 weeks of gestation from the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS) biobank and measured IFNε by enzyme‐linked immunosorbent assay (ELISA). A total of 29 women with spontaneous preterm births, 34 women with medically indicated preterm births, and 134 women with term births were included. Secondary outcomes included a preterm birth with chorioamnionitis and preeclampsia with a preterm birth. Logistic regression calculated odds ratios (OR) and 95% confidence intervals (CI) adjusting for maternal age, race, body mass index, prior pregnancy complications, lower genital tract infections, chronic health conditions, and gestational age at blood draw. Results and Conclusions: There was no significant association between IFNε and spontaneous preterm birth (ORadj 1.0, 0.8–1.3) or chorioamnionitis (ORadj 1.6, 0.7–3.5). A trend toward increased odds of medically indicated preterm birth (ORadj. 1.3, 1.0–1.8) was observed. This was likely due to elevated IFNε among women with preterm preeclampsia (ORadj. 2.0, 95% CI 1.3–3.2). While exploratory, our novel findings suggest that larger longitudinal studies of IFNε across human pregnancy may be warranted. [ABSTRACT FROM AUTHOR]

Short-chain fatty acids (SCFAs) are by-products from microbial metabolism of fibers with anti-inflammatory effects. SCFAs may mitigate inflammatory conditions such as obesity through modulation of histone acetylation. Lipid metabolism and inflammation play critical roles during pregnancy. However, few studies have examined maternal SCFAs in relation to pregnancy outcomes. This pilot study examined plasma SCFAs in spontaneous preterm birth. This study used stored plasma from an existing cohort to measure seven (proponic acid, methanoic acid, butanoic acid, isovaleric acid, pentanoic acid, methylpropylbutanoic and methylbutanoic acids) SCFAs in 20 women with spontaneous preterm delivery (< 37 weeks gestation) and 30 women with a healthy term delivery (≥ 37 weeks gestation). All women had singleton pregnancies and provided serum at the time of admission to labor and delivery. SCFAs were measured by purge and trap gas chromatography/mass spectrometry. SCFAs were log transformed. Logistic regression with penalized likelihood approach examined associations between SCFAs and preterm birth, adjusting for age, BMI, and race. We also explored if SCFAs had a linear association with pre-pregnancy BMI. Propionic acid had a negative association with preterm birth [odds ratioadj: 0.56, 95% confidence interval 0.41–0.86). There was a negative association between propionic acid and BMI after adjustments (β = −0.14, p = 0.0011). No other associations were found. Lower levels of propionic acid were associated with preterm birth and correlated with higher BMI. Larger studies should explore if circulatory SCFAs protect against inflammatory pathways during pregnancy and are associated with adverse outcomes when measured earlier in pregnancy. [ABSTRACT FROM AUTHOR]