{"doi":"10.1093/infdis/jiab277","title":"Chlamydia, Gonorrhea, and Incident HIV Infection During Pregnancy Predict Preterm Birth Despite Treatment","abstract":"BACKGROUND: Identifying predictors of preterm birth (PTB) in high-burden regions is important as PTB is the leading cause of global child mortality. METHODS: This analysis was nested in a longitudinal study of human immunodeficiency virus (HIV) incidence in Kenya. HIV-seronegative women enrolled in pregnancy had nucleic acid amplification tests (chlamydia and gonorrhea), rapid plasma reagin (syphilis), wet mount microscopy (Trichomonas and yeast), and Gram stain (bacterial vaginosis); sexually transmitted infection (STI) treatment was provided. PTB predictors were determined using log-binomial regression. RESULTS: Among 1244 mothers of liveborn infants, median gestational age at enrollment was 26 weeks (IQR, 22-31), and at delivery was 39.1 weeks (IQR, 37.1-40.9). PTB occurred in 302 women (24.3%). Chlamydia was associated with a 1.59-fold (P = .006), gonorrhea a 1.62-fold (P = .04), and incident HIV a 2.08-fold (P = .02) increased PTB prevalence. Vaginal discharge and cervical inflammation were associated with PTB, as were age ≤21 (prevalence ratio [PR] = 1.39, P = .001) and any STI (PR = 1.47, P = .001). Associations with chlamydia and incident HIV remained in multivariable models. CONCLUSIONS: STIs and incident HIV in pregnancy predicted PTB despite treatment, suggesting the need for earlier treatment and interventions to decrease genital inflammation.","journal":"The Journal of Infectious Diseases","year":2021,"id":160696,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":33,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9484,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":407491,"name":"Barbra A. Richardson","orcid":"0000-0001-9564-1828","position":1,"is_corresponding":false},{"id":299054,"name":"John Kinuthia","orcid":"0000-0001-6571-8927","position":2,"is_corresponding":false},{"id":674698,"name":"Jennifer A Unger","orcid":null,"position":3,"is_corresponding":false},{"id":315410,"name":"Alison L. Drake","orcid":"0000-0002-4178-7706","position":4,"is_corresponding":false},{"id":541204,"name":"Lusi Osborn","orcid":"0000-0002-7100-2666","position":5,"is_corresponding":false},{"id":445175,"name":"Daniel Matemo","orcid":"0000-0002-7209-1648","position":6,"is_corresponding":false},{"id":674050,"name":"Janna Patterson","orcid":"0000-0001-6275-4017","position":7,"is_corresponding":false},{"id":407493,"name":"R. Scott McClelland","orcid":"0000-0003-2574-4201","position":8,"is_corresponding":false},{"id":299048,"name":"Grace John‐Stewart","orcid":"0000-0002-4301-1573","position":9,"is_corresponding":false},{"id":674697,"name":"J Ravindran","orcid":null,"position":0,"is_corresponding":true}],"reference_count":53,"raw_metadata":null,"created_at":"2026-07-18T23:44:48.240577Z","pmid":"34023871","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}