PMID- 29795625
OWN - NLM
STAT- MEDLINE
DCOM- 20181126
LR  - 20181126
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 13
IP  - 5
DP  - 2018
TI  - Incidence of sexually transmitted infections during pregnancy.
PG  - e0197696
LID - 10.1371/journal.pone.0197696 [doi]
AB  - Prevalence of sexually transmitted infections (STI) is high among pregnant women 
      in certain settings. We estimated STI incidence and compared STI risk in pregnant
      and non-pregnant women. Data came from the Methods for Improving Reproductive
      Health in Africa (MIRA) study conducted in South Africa and Zimbabwe 2003-2006.
      Women aged 18-50 years with at least one follow-up visit within 6 months of
      enrollment were included. Follow-up visits included laboratory testing for
      pregnancy, chlamydia, gonorrhea, trichomoniasis, and HIV, as well as self-report 
      of hormonal contraceptive (HC) use, sexual behaviors and intravaginal practices. 
      All visits were classified according to pregnancy status. Incidence of each STI
      was calculated using follow-up time. Cox proportional hazards models were fitted 
      using pregnancy as a time-varying exposure and sexual behaviors and intravaginal 
      practices as time-varying covariates. Among 4,549 women, 766 (16.8%) had a
      positive pregnancy test. Median follow-up time was 18 months [IQR: 12-24]. The
      overall incidence rate of chlamydia was 6.7 per 100 person years (py) and
      9.9/100py during pregnancy; gonorrhea incidence was 2.7/100py and 4.9/100py
      during pregnancy; trichomoniasis incidence was 7.1/100py overall and 9.2/100py
      during pregnancy. Overall HIV incidence was 3.9/100py and 3.8/100py during
      pregnancy. In crude models, pregnancy increased risk for chlamydia (hazard ratio 
      (HR) 1.5, 95%CI: 1.1-1.2), however there was no increased risk of any measured
      STI in adjusted models. STI Incidence was high during pregnancy however pregnancy
      did not increase STI risk after adjustment for sexual behaviors. Greater efforts 
      are needed to help pregnant women avoid STIs.
FAU - Teasdale, Chloe A
AU  - Teasdale CA
AUID- ORCID: 0000-0001-9165-8972
AD  - ICAP, Mailman School of Public Health, Columbia University, New York, NY, United 
      States of America.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, NY, United States of America.
FAU - Abrams, Elaine J
AU  - Abrams EJ
AD  - ICAP, Mailman School of Public Health, Columbia University, New York, NY, United 
      States of America.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, NY, United States of America.
FAU - Chiasson, Mary Ann
AU  - Chiasson MA
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, NY, United States of America.
FAU - Justman, Jessica
AU  - Justman J
AD  - ICAP, Mailman School of Public Health, Columbia University, New York, NY, United 
      States of America.
AD  - Department of Epidemiology, Mailman School of Public Health, Columbia University,
      New York, NY, United States of America.
FAU - Blanchard, Kelly
AU  - Blanchard K
AD  - Ibis Reproductive Health, Cambridge, MA, United States of America.
FAU - Jones, Heidi E
AU  - Jones HE
AUID- ORCID: 0000-0002-4285-3752
AD  - Department of Epidemiology, City University of New York School of Public Health, 
      New York, NY, United States of America.
LA  - eng
SI  - ClinicalTrials.gov/NCT00121459
PT  - Journal Article
DEP - 20180524
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Chlamydia Infections/diagnosis/epidemiology
MH  - Female
MH  - Gonorrhea/diagnosis/epidemiology
MH  - HIV Infections/diagnosis/epidemiology
MH  - Humans
MH  - Incidence
MH  - Middle Aged
MH  - Pregnancy
MH  - Pregnancy Complications, Infectious/*epidemiology
MH  - Proportional Hazards Models
MH  - Risk
MH  - Sexual Behavior
MH  - Sexually Transmitted Diseases/diagnosis/*epidemiology
MH  - South Africa/epidemiology
MH  - Trichomonas Infections/diagnosis/epidemiology
MH  - Young Adult
MH  - Zimbabwe/epidemiology
PMC - PMC5967814
COIS- The authors have declared that no competing interests exist.
EDAT- 2018/05/26 06:00
MHDA- 2018/11/27 06:00
CRDT- 2018/05/26 06:00
PHST- 2017/09/18 00:00 [received]
PHST- 2018/05/07 00:00 [accepted]
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/11/27 06:00 [medline]
AID - 10.1371/journal.pone.0197696 [doi]
AID - PONE-D-17-33858 [pii]
PST - epublish
SO  - PLoS One. 2018 May 24;13(5):e0197696. doi: 10.1371/journal.pone.0197696.
      eCollection 2018.