The association between non-viral sexually transmitted infections and pregnancy outcome in Latin America and the Caribbean: A systematic review

Maria Lara-Escandell; Carlotta Gamberini; Naomi C A Juliana; Salwan Al-Nasiry; Servaas A Morré; Elena Ambrosino

doi:10.1016/j.heliyon.2023.e23338

The association between non-viral sexually transmitted infections and pregnancy outcome in Latin America and the Caribbean: A systematic review

Heliyon. 2023 Dec 13;10(1):e23338. doi: 10.1016/j.heliyon.2023.e23338. eCollection 2024 Jan 15.

Authors

Maria Lara-Escandell¹, Carlotta Gamberini¹, Naomi C A Juliana¹, Salwan Al-Nasiry^{1

2}, Servaas A Morré^{1

3

4}, Elena Ambrosino¹

Affiliations

¹ Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Research School GROW for Oncology and Reproduction, Faculty of Health, Medicine & Life Sciences, University of Maastricht, 6229 ER Maastricht, the Netherlands.
² Department of Obstetrics and Gynecology, Maastricht University Medical Centre+, Maastricht, the Netherlands.
³ Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad 211007, UP, India.
⁴ Dutch Chlamydia Trachomatis Reference Laboratory on Behalf of the Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, the Netherlands.

Abstract

Introduction: Non-viral sexually transmitted infections are known to be associated with adverse pregnancy outcomes. For these pathogens, standard antenatal screening is not broadly performed in Latin America and the Caribbean. The aim of this study was to comprehensively review the association of non-viral sexually transmitted infections and neonatal outcomes among pregnant women in the region.

Methods: Four databases (PubMed, Embase, SciELO and LILACS) were examined to identify eligible studies published up to September 2022. English or Spanish cross-sectional, case-control and cohort studies assessing the association of non-viral sexually transmitted infections and adverse pregnancy outcomes were evaluated. Articles were firstly screened by means of title and abstract. Potential articles were fully read and assessed for inclusion according to the eligibility criteria. Snowballing search was performed by screening of bibliographies of the chosen potentially relevant papers. Risk of bias within studies was assessed using the Joanna Briggs Institute reviewer's manual.

Results: A selection of 10 out of 9772 search records from five Latin America and the Caribbean countries were included. Six studies associated Treponema pallidum infection with preterm birth (1/6), history of previous spontaneous abortion (2/6), fetal and infant death (1/6), low birth weight (1/6) and funisitis of the umbilical cord (1/6). Three studies associated Chlamydia trachomatis infection with preterm birth (2/3), ectopic pregnancy (1/3) and respiratory symptoms on the newborn (1/3). One study associated Mycoplasma genitalium infection with preterm birth.

Conclusion: This review provides evidence on the association of non-viral sexually transmitted infections with adverse pregnancy outcomes. Further investigation is needed to establish more associations between non-viral sexually transmitted infections and pregnancy outcome, especially for Mycoplasma genitalium, Trichomonas vaginalis and Neisseria gonorrhoeae. Overall, this review calls for more research for public health interventions to promote screening of non-viral sexually transmitted infections during pregnancy, among high-risk population groups of pregnant women living in the region.

Keywords: Adverse pregnancy outcomes; Latin America and the Caribbean (LAC); Sexually transmitted infections (STI).