Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol

doi:10.1136/bmjopen-2018-024175

. 2018 Nov 28;8(11):e024175.

doi: 10.1136/bmjopen-2018-024175.

Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol

Lisa M Vallely^#¹, Dianne Egli-Gany^#², William Pomat³, Caroline Se Homer^{4

5}, Rebecca Guy⁶, Handan Wand⁷, Bronwyn Silver⁸, Alice R Rumbold⁹, John M Kaldor¹, Nicola Low², Andrew J Vallely^{1

10}

Affiliations

¹ Public Health Interventions Research Group, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
² Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
³ Director, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
⁴ Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
⁵ Co-Program Director Maternal and Child Health, Burnet Institute, Melbourne, Victoria, Australia.
⁶ Surveillance and Evaluation Research, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Biostatistics and Databases program, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁸ Public Health Division, Central Australian Aboriginal Congress, Alice Springs, Australia.
⁹ Robinson Research Institute, University of Adelaide, Adelaide, Australia.
¹⁰ Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.

^# Contributed equally.

PMID: 30498048
PMCID: PMC6278811
DOI: 10.1136/bmjopen-2018-024175

Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol

Lisa M Vallely et al. BMJ Open. 2018.

. 2018 Nov 28;8(11):e024175.

doi: 10.1136/bmjopen-2018-024175.

Authors

Affiliations

¹ Public Health Interventions Research Group, Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
² Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
³ Director, Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province, Papua New Guinea.
⁴ Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia.
⁵ Co-Program Director Maternal and Child Health, Burnet Institute, Melbourne, Victoria, Australia.
⁶ Surveillance and Evaluation Research, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁷ Biostatistics and Databases program, The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
⁸ Public Health Division, Central Australian Aboriginal Congress, Alice Springs, Australia.
⁹ Robinson Research Institute, University of Adelaide, Adelaide, Australia.
¹⁰ Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.

^# Contributed equally.

PMID: 30498048
PMCID: PMC6278811
DOI: 10.1136/bmjopen-2018-024175

Abstract

Introduction: Several bacterial sexually transmitted and genital mycoplasma infections during pregnancy have been associated with poor pregnancy and perinatal outcomes. Comprehensive and systematic information about associations between sexually transmitted infections (STI) and genital infections in pregnancy and adverse perinatal outcomes is needed to improve understanding about the evidence for causal associations between these infections and adverse pregnancy and neonatal outcomes. Our primary objective is to systematically review the literature about associations between: (1) Neisseria gonorrhoeae in pregnancy and preterm birth; (2) Mycoplasma genitalium in pregnancy and preterm birth; (3) M. hominis, Ureaplasma urealyticum and/or U. parvum in pregnancy and preterm birth.

Methods and analysis: We will undertake a systematic search of Medline, Excerpta Medica database and the Cochrane Library and Cumulative Index to Nursing and Allied Health Literature. Following an initial screening of titles by one reviewer, abstracts will be independently assessed by two reviewers before screening of full-text articles. To exclude a manuscript, both reviewers need to agree on the decision. Any discrepancies will be resolved by discussion, or the adjudication of a third reviewer. Studies will be included if they report testing for one or more of N. gonorrhoeae, M. genitalium, M. hominis, U. urealyticum and/or U. parvum during pregnancy and report pregnancy and/or birth outcomes. In this review, the primary outcome is preterm birth. Secondary outcomes are premature rupture of membranes, low birth weight, spontaneous abortion, stillbirth, neonatal mortality and ophthalmia neonatorum. We will use standard definitions, or definitions reported by study authors. We will examine associations between exposure and outcome in forest plots, using the I² statistic to examine between study heterogeneity. Where appropriate, we will use meta-analysis to combine results of individual studies.

Ethics and dissemination: This systematic review of published literature does not require ethical committee approval. Results of this review will be published in a peer reviewed, open access journal.

Prospero registration number: CRD42016050962.

Keywords: adverse pregnancy outcome; genital mycoplasmas; meta analysis; preterm birth; sexually transmitted infections; systematic review.

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Conflict of interest statement

Competing interests: None declared.

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Sexually Transmitted Infections in Pregnancy: A Narrative Review of the Global Research Gaps, Challenges, and Opportunities.
Grant JS, Chico RM, Lee AC, Low N, Medina-Marino A, Molina RL, Morroni C, Ramogola-Masire D, Stafylis C, Tang W, Vallely AJ, Wynn A, Yeganeh N, Klausner JD. Grant JS, et al. Sex Transm Dis. 2020 Dec;47(12):779-789. doi: 10.1097/OLQ.0000000000001258. Sex Transm Dis. 2020. PMID: 32773611 Free PMC article. Review.
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References

1. Mullick S, Watson-Jones D, Beksinska M, et al. . Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect 2005;81:294–302. 10.1136/sti.2002.004077 - DOI - PMC - PubMed
1. Blas MM, Canchihuaman FA, Alva IE, et al. . Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sex Transm Infect 2007;83:314–8. 10.1136/sti.2006.022665 - DOI - PMC - PubMed
1. Cotch MF, Pastorek JG, Nugent RP, et al. . Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infections and Prematurity Study Group. Sex Transm Dis 1997;24:353–60. - PubMed
1. Gravett MG, Nelson HP, DeRouen T, et al. . Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA 1986;256:1899–903. 10.1001/jama.1986.03380140069024 - DOI - PubMed
1. Chow JM, Kang MS, Samuel MC, et al. . Assessment of the association of chlamydia trachomatis infection and adverse perinatal outcomes with the use of population-based chlamydia case report registries and birth records. Public Health Rep 2009;124 Suppl 2:24–30. 10.1177/00333549091240S205 - DOI - PMC - PubMed

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[1] Mullick S, Watson-Jones D, Beksinska M, et al. . Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect 2005;81:294–302. 10.1136/sti.2002.004077 - DOI - PMC - PubMed

[2] Mullick S, Watson-Jones D, Beksinska M, et al. . Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect 2005;81:294–302. 10.1136/sti.2002.004077 - DOI - PMC - PubMed

[3] Blas MM, Canchihuaman FA, Alva IE, et al. . Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sex Transm Infect 2007;83:314–8. 10.1136/sti.2006.022665 - DOI - PMC - PubMed

[4] Blas MM, Canchihuaman FA, Alva IE, et al. . Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sex Transm Infect 2007;83:314–8. 10.1136/sti.2006.022665 - DOI - PMC - PubMed

[5] Cotch MF, Pastorek JG, Nugent RP, et al. . Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infections and Prematurity Study Group. Sex Transm Dis 1997;24:353–60. - PubMed

[6] Cotch MF, Pastorek JG, Nugent RP, et al. . Trichomonas vaginalis associated with low birth weight and preterm delivery. The Vaginal Infections and Prematurity Study Group. Sex Transm Dis 1997;24:353–60. - PubMed

[7] Gravett MG, Nelson HP, DeRouen T, et al. . Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA 1986;256:1899–903. 10.1001/jama.1986.03380140069024 - DOI - PubMed

[8] Gravett MG, Nelson HP, DeRouen T, et al. . Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA 1986;256:1899–903. 10.1001/jama.1986.03380140069024 - DOI - PubMed

[9] Chow JM, Kang MS, Samuel MC, et al. . Assessment of the association of chlamydia trachomatis infection and adverse perinatal outcomes with the use of population-based chlamydia case report registries and birth records. Public Health Rep 2009;124 Suppl 2:24–30. 10.1177/00333549091240S205 - DOI - PMC - PubMed

[10] Chow JM, Kang MS, Samuel MC, et al. . Assessment of the association of chlamydia trachomatis infection and adverse perinatal outcomes with the use of population-based chlamydia case report registries and birth records. Public Health Rep 2009;124 Suppl 2:24–30. 10.1177/00333549091240S205 - DOI - PMC - PubMed

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Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol

Affiliations

Adverse pregnancy and neonatal outcomes associated with Neisseria gonorrhoeae, Mycoplasma genitalium, M. hominis, Ureaplasma urealyticum and U. parvum: a systematic review and meta-analysis protocol

Authors

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Abstract

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Abstract

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