PMID- 28396556
OWN - NLM
STAT- MEDLINE
DCOM- 20180115
LR  - 20191008
IS  - 1472-3263 (Electronic)
IS  - 1368-4973 (Linking)
VI  - 93
IP  - 7
DP  - 2017 Nov
TI  - Pregnancy Outcomes in Association with STDs including genital HSV-2 shedding in a 
      South African Cohort Study.
PG  - 460-466
LID - 10.1136/sextrans-2017-053113 [doi]
AB  - OBJECTIVES: Genital herpes simplex virus-2 (HSV-2) shedding in pregnant women in 
      association with neonatal herpes infection has been widely studied but there is 
      limited evidence of its association with pregnancy outcomes. METHODS: In this 
      retrospective observational study, we included a subgroup of pregnant women who 
      were enrolled in a randomized control behavioural intervention study that was 
      conducted in South Africa in 2008-2010. In pregnancy, women had a HIV rapid test 
      done and a genital swab taken to test for curable STIs and HSV-2 DNA. Subsequent 
      visits were scheduled for 6, 10, 14 weeks and 9 months post-delivery. Pregnancy 
      outcomes were documented at the 6-week or 10-week postpartum visit. Women were 
      treated syndromically for curable STIs. RESULTS: Among 615 women included in this 
      data analysis, 36.6% (n=225) tested HIV positive and 8.3% (n=51) tested positive 
      for genital HSV-2 shedding during pregnancy. Women <24 years and HIV-1 
      seropositive women were 1.5 and 2.5 times more likely to test positive for HSV-2 
      genital shedding respectively. STI treatment records were available for 158/205 
      (77.1%) women; all 87 women with symptomatic STIs were treated the same day, and 
      50/71 (70.4%) asymptomatic women received treatment at the subsequent visit. 
      Remaining 21 (29.6%) asymptomatic women did not receive treatment because they 
      failed to return for antenatal follow-up. In a multivariable regression analysis, 
      genital HSV-2 shedding, HIV-1, Neisseria gonorrhoea, Chlamydia trachomatis and 
      Trichomanas vaginalis were not associated with preterm deliveries, still births 
      and low birth weight. However with stratification by treatment for a STI, 
      asymptomatic women who were not treated were 3.3 times more likely to deliver 
      prematurely (33.3%; n=6/18) when compared to women who were treated during 
      pregnancy (13.2%; n=15/114) (p=0.042). CONCLUSIONS: Genital HSV-2 shedding in 
      pregnancy does not appear to alter pregnancy outcomes. Untreated curable STIs 
      (T.vaginalis, C.trachomatis, N.gonorrhoea) were more likely associated with 
      preterm births.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://www.bmj.com/company/products-services/rights-and-licensing/.
FAU - Moodley, Dhayendre
AU  - Moodley D
AD  - Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, 
      South Africa.
FAU - Sartorius, Benn
AU  - Sartorius B
AD  - Discipline of Public Health Medicine, School of Nursing and Public Health, 
      College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
FAU - Madurai, Savithree
AU  - Madurai S
AD  - Global Clinical Virology Laboratory, Durban, South Africa.
FAU - Chetty, Vani
AU  - Chetty V
AD  - Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, 
      South Africa.
FAU - Maman, Suzanne
AU  - Maman S
AD  - Department of Health Behavior, Gillings School of Global Public Health, 
      University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
LA  - eng
GR  - R01 HD050134/HD/NICHD NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20170410
PL  - England
TA  - Sex Transm Infect
JT  - Sexually transmitted infections
JID - 9805554
RN  - Neonatal herpes
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Ambulatory Care Facilities
MH  - Chlamydia Infections/epidemiology/microbiology/physiopathology
MH  - Female
MH  - Gonorrhea/epidemiology/microbiology/physiopathology
MH  - HIV Infections/epidemiology/physiopathology/virology
MH  - Herpes Genitalis/epidemiology/physiopathology/virology
MH  - Herpes Simplex/epidemiology/physiopathology/virology
MH  - Herpesvirus 2, Human/growth & development/*physiology
MH  - Humans
MH  - Point-of-Care Testing
MH  - Pregnancy
MH  - *Pregnancy Complications, 
      Infectious/epidemiology/microbiology/physiopathology/virology
MH  - Pregnancy Outcome
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
MH  - *Sexually Transmitted Diseases/epidemiology/microbiology/virology
MH  - South Africa
MH  - *Virus Shedding
MH  - Young Adult
OTO - NOTNLM
OT  - CHLAMYDIA TRACHOMATIS
OT  - GENITAL HERPES
OT  - NEISSERIA GONORRHOEA
OT  - TRICHOMONAS
COIS- Competing interests: None declared.
EDAT- 2017/04/12 06:00
MHDA- 2018/01/16 06:00
CRDT- 2017/04/12 06:00
PHST- 2017/01/19 00:00 [received]
PHST- 2017/03/02 00:00 [revised]
PHST- 2017/03/14 00:00 [accepted]
PHST- 2017/04/12 06:00 [pubmed]
PHST- 2018/01/16 06:00 [medline]
PHST- 2017/04/12 06:00 [entrez]
AID - sextrans-2017-053113 [pii]
AID - 10.1136/sextrans-2017-053113 [doi]
PST - ppublish
SO  - Sex Transm Infect. 2017 Nov;93(7):460-466. doi: 10.1136/sextrans-2017-053113. 
      Epub 2017 Apr 10.