Preterm birth is the leading cause of perinatal morbidity and mortality. The risks of preterm birth are heterogeneous and there remains much to elucidate regarding etiology and epidemiology of this perinatal condition. Maternal genitourinary tract infection may reduce the length of gestation through premature rupture of membranes and/or preterm labor. Specifically, antenatal infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae, both high prevalence sexually-transmitted infections, may convey a higher risk of preterm birth. Early detection and treatment of these infections without recurrent/persistent infection during pregnancy may serve as an effective intervention that protects against preterm birth. The objective of this study was to characterize the association between early antenatal detection and eradication of Chlamydia trachomatis and/or Neisseria gonorrhoeae infection and the likelihood of preterm birth among pregnant women in an urban county.
A retrospective cohort study was conducted in Hamilton County, Ohio (2006-2011) to evaluate the risk of preterm birth among women whose infections were detected and eradicated at or before 20 weeks gestation (intervention cohort). The risk of preterm birth in this intervention cohort was compared to that in a cohort of women whose infections were detected late (> 20 weeks gestation) or were recurrent/persistent (= 20 weeks and >20 weeks gestation) during pregnancy. A novel approach was used to measure the timing and frequency of Chlamydia trachomatis and/or Neisseria gonorrhoeae detection and subsequent adverse pregnancy outcomes through the use of linked population-based public health data.
The study population contained 3,912 linked birth-communicable disease records (i.e., maternal Chlamydia trachomatis and/or Neisseria gonorrhoeae infection). The relative risk of moderate to late preterm birth (32-36 weeks gestation) was 0.54 (95% CI: 0.37-0.80) for women in the intervention cohort who were 19 years of age and younger and were infected with Chlamydia trachomatis during pregnancy. The same protective finding was not identified for women in the intervention cohort with Neisseria gonorrhoeae infections during pregnancy. Instead, women in the intervention cohort with Neisseria gonorrhoeae infections had a significantly increased risk of preterm birth (relative risk 1.41, 95% CI: 1.05-1.90); however, this risk was not present in women who had only a single infection detected early during pregnancy. Women in the intervention cohort with serial Neisseria gonorrhoeae infections had relative risks for very preterm birth (<32 weeks gestation) and spontaneous very preterm birth that were 2.30 (95% CI: 1.07-4.95) and 2.74 (95% CI: 1.08-6.94), respectively.
The findings underscore the importance of early antenatal detection and eradication of Chlamydia trachomatis and Neisseria gonorrhoeae. Adolescent women are known to have a higher risk for Chlamydia trachomatis infections than the risk among older women; early and effective antenatal intervention for Chlamydia trachomatis may protect these women from having moderate to late preterm birth. Furthermore, women infected with Neisseria gonorrhoeae in the early stages of pregnancy, and particularly those with recurrent/persistent infection early, may be at an increased risk for preterm birth and very preterm birth. The pathogenic effects on pregnancy could be reversed with early, effective intervention.
","abstract_html":"<p>Preterm birth is the leading cause of perinatal morbidity and mortality. The risks of preterm birth are heterogeneous and there remains much to elucidate regarding etiology and epidemiology of this perinatal condition. Maternal genitourinary tract infection may reduce the length of gestation through premature rupture of membranes and/or preterm labor. Specifically, antenatal infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae, both high prevalence sexually-transmitted infections, may convey a higher risk of preterm birth. Early detection and treatment of these infections without recurrent/persistent infection during pregnancy may serve as an effective intervention that protects against preterm birth. The objective of this study was to characterize the association between early antenatal detection and eradication of Chlamydia trachomatis and/or Neisseria gonorrhoeae infection and the likelihood of preterm birth among pregnant women in an urban county. </p><p>A retrospective cohort study was conducted in Hamilton County, Ohio (2006-2011) to evaluate the risk of preterm birth among women whose infections were detected and eradicated at or before 20 weeks gestation (intervention cohort). The risk of preterm birth in this intervention cohort was compared to that in a cohort of women whose infections were detected late (> 20 weeks gestation) or were recurrent/persistent (= 20 weeks and >20 weeks gestation) during pregnancy. A novel approach was used to measure the timing and frequency of Chlamydia trachomatis and/or Neisseria gonorrhoeae detection and subsequent adverse pregnancy outcomes through the use of linked population-based public health data.</p><p>The study population contained 3,912 linked birth-communicable disease records (i.e., maternal Chlamydia trachomatis and/or Neisseria gonorrhoeae infection). The relative risk of moderate to late preterm birth (32-36 weeks gestation) was 0.54 (95% CI: 0.37-0.80) for women in the intervention cohort who were 19 years of age and younger and were infected with Chlamydia trachomatis during pregnancy. The same protective finding was not identified for women in the intervention cohort with Neisseria gonorrhoeae infections during pregnancy. Instead, women in the intervention cohort with Neisseria gonorrhoeae infections had a significantly increased risk of preterm birth (relative risk 1.41, 95% CI: 1.05-1.90); however, this risk was not present in women who had only a single infection detected early during pregnancy. Women in the intervention cohort with serial Neisseria gonorrhoeae infections had relative risks for very preterm birth (<32 weeks gestation) and spontaneous very preterm birth that were 2.30 (95% CI: 1.07-4.95) and 2.74 (95% CI: 1.08-6.94), respectively. </p><p>The findings underscore the importance of early antenatal detection and eradication of Chlamydia trachomatis and Neisseria gonorrhoeae. Adolescent women are known to have a higher risk for Chlamydia trachomatis infections than the risk among older women; early and effective antenatal intervention for Chlamydia trachomatis may protect these women from having moderate to late preterm birth. Furthermore, women infected with Neisseria gonorrhoeae in the early stages of pregnancy, and particularly those with recurrent/persistent infection early, may be at an increased risk for preterm birth and very preterm birth. The pathogenic effects on pregnancy could be reversed with early, effective intervention.</p>","abstract_has_math":false,"creators":["Folger, Alonzo T., V"],"institution":"University of Cincinnati","degree_name":"PhD","degree_level":"doctoral","degree_discipline":"Medicine: Epidemiology (Environmental Health)","degree_department":null,"school":null,"contributors":["Dietrich, Kim"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2012,"date_issued":"2012","date_published":"2012","updated_at":"2026-07-24T03:36:23Z","subjects":["Epidemiology","Chlamydia trachomatis","Neisseria gonorrhoeae","Preterm Birth","Antenatal Infection","Deterministic Linking"],"languages":["English"],"rights":["unrestricted","This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws."],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353098416","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Dietrich, Kim"]},{"key":"dc:creator","label":"Author","values":["Folger, Alonzo T., V"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2012"]},{"key":"dc:publisher","label":"Institution","values":["University of Cincinnati / OhioLINK"]},{"key":"dc:type","label":"Dc Type","values":["Electronic Thesis or Dissertation"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Medicine: Epidemiology (Environmental Health)"]},{"key":"thesis:degree_level","label":"Degree Level","values":["doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["University of Cincinnati"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Epidemiology","Chlamydia trachomatis","Neisseria gonorrhoeae","Preterm Birth","Antenatal Infection","Deterministic Linking"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["English"]},{"key":"dc:rights","label":"Dc Rights","values":["unrestricted","This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws."]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353098416"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Preterm birth is the leading cause of perinatal morbidity and mortality. The risks of preterm birth are heterogeneous and there remains much to elucidate regarding etiology and epidemiology of this perinatal condition. Maternal genitourinary tract infection may reduce the length of gestation through premature rupture of membranes and/or preterm labor. Specifically, antenatal infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae, both high prevalence sexually-transmitted infections, may convey a higher risk of preterm birth. Early detection and treatment of these infections without recurrent/persistent infection during pregnancy may serve as an effective intervention that protects against preterm birth. The objective of this study was to characterize the association between early antenatal detection and eradication of Chlamydia trachomatis and/or Neisseria gonorrhoeae infection and the likelihood of preterm birth among pregnant women in an urban county.
A retrospective cohort study was conducted in Hamilton County, Ohio (2006-2011) to evaluate the risk of preterm birth among women whose infections were detected and eradicated at or before 20 weeks gestation (intervention cohort). The risk of preterm birth in this intervention cohort was compared to that in a cohort of women whose infections were detected late (> 20 weeks gestation) or were recurrent/persistent (= 20 weeks and >20 weeks gestation) during pregnancy. A novel approach was used to measure the timing and frequency of Chlamydia trachomatis and/or Neisseria gonorrhoeae detection and subsequent adverse pregnancy outcomes through the use of linked population-based public health data.
The study population contained 3,912 linked birth-communicable disease records (i.e., maternal Chlamydia trachomatis and/or Neisseria gonorrhoeae infection). The relative risk of moderate to late preterm birth (32-36 weeks gestation) was 0.54 (95% CI: 0.37-0.80) for women in the intervention cohort who were 19 years of age and younger and were infected with Chlamydia trachomatis during pregnancy. The same protective finding was not identified for women in the intervention cohort with Neisseria gonorrhoeae infections during pregnancy. Instead, women in the intervention cohort with Neisseria gonorrhoeae infections had a significantly increased risk of preterm birth (relative risk 1.41, 95% CI: 1.05-1.90); however, this risk was not present in women who had only a single infection detected early during pregnancy. Women in the intervention cohort with serial Neisseria gonorrhoeae infections had relative risks for very preterm birth (<32 weeks gestation) and spontaneous very preterm birth that were 2.30 (95% CI: 1.07-4.95) and 2.74 (95% CI: 1.08-6.94), respectively.
The findings underscore the importance of early antenatal detection and eradication of Chlamydia trachomatis and Neisseria gonorrhoeae. Adolescent women are known to have a higher risk for Chlamydia trachomatis infections than the risk among older women; early and effective antenatal intervention for Chlamydia trachomatis may protect these women from having moderate to late preterm birth. Furthermore, women infected with Neisseria gonorrhoeae in the early stages of pregnancy, and particularly those with recurrent/persistent infection early, may be at an increased risk for preterm birth and very preterm birth. The pathogenic effects on pregnancy could be reversed with early, effective intervention.
"]},{"key":"dc:format","label":"Dc Format","values":["application/pdf","p.48","809. KB"]},{"key":"dc:title","label":"Title","values":["Maternal Chlamydia trachomatis and Neisseria gonorrhoeae Infections and the Outcome of Preterm Birth: The Impact of Early Detection"]}]}],"canonical_facts":{"dc:contributor":["Dietrich, Kim"],"dc:creator":["Folger, Alonzo T., V"],"dc:date":["2012"],"dc:description":["Preterm birth is the leading cause of perinatal morbidity and mortality. The risks of preterm birth are heterogeneous and there remains much to elucidate regarding etiology and epidemiology of this perinatal condition. Maternal genitourinary tract infection may reduce the length of gestation through premature rupture of membranes and/or preterm labor. Specifically, antenatal infection with Chlamydia trachomatis and/or Neisseria gonorrhoeae, both high prevalence sexually-transmitted infections, may convey a higher risk of preterm birth. Early detection and treatment of these infections without recurrent/persistent infection during pregnancy may serve as an effective intervention that protects against preterm birth. The objective of this study was to characterize the association between early antenatal detection and eradication of Chlamydia trachomatis and/or Neisseria gonorrhoeae infection and the likelihood of preterm birth among pregnant women in an urban county.
A retrospective cohort study was conducted in Hamilton County, Ohio (2006-2011) to evaluate the risk of preterm birth among women whose infections were detected and eradicated at or before 20 weeks gestation (intervention cohort). The risk of preterm birth in this intervention cohort was compared to that in a cohort of women whose infections were detected late (> 20 weeks gestation) or were recurrent/persistent (= 20 weeks and >20 weeks gestation) during pregnancy. A novel approach was used to measure the timing and frequency of Chlamydia trachomatis and/or Neisseria gonorrhoeae detection and subsequent adverse pregnancy outcomes through the use of linked population-based public health data.
The study population contained 3,912 linked birth-communicable disease records (i.e., maternal Chlamydia trachomatis and/or Neisseria gonorrhoeae infection). The relative risk of moderate to late preterm birth (32-36 weeks gestation) was 0.54 (95% CI: 0.37-0.80) for women in the intervention cohort who were 19 years of age and younger and were infected with Chlamydia trachomatis during pregnancy. The same protective finding was not identified for women in the intervention cohort with Neisseria gonorrhoeae infections during pregnancy. Instead, women in the intervention cohort with Neisseria gonorrhoeae infections had a significantly increased risk of preterm birth (relative risk 1.41, 95% CI: 1.05-1.90); however, this risk was not present in women who had only a single infection detected early during pregnancy. Women in the intervention cohort with serial Neisseria gonorrhoeae infections had relative risks for very preterm birth (<32 weeks gestation) and spontaneous very preterm birth that were 2.30 (95% CI: 1.07-4.95) and 2.74 (95% CI: 1.08-6.94), respectively.
The findings underscore the importance of early antenatal detection and eradication of Chlamydia trachomatis and Neisseria gonorrhoeae. Adolescent women are known to have a higher risk for Chlamydia trachomatis infections than the risk among older women; early and effective antenatal intervention for Chlamydia trachomatis may protect these women from having moderate to late preterm birth. Furthermore, women infected with Neisseria gonorrhoeae in the early stages of pregnancy, and particularly those with recurrent/persistent infection early, may be at an increased risk for preterm birth and very preterm birth. The pathogenic effects on pregnancy could be reversed with early, effective intervention.
"],"dc:format":["application/pdf","p.48","809. KB"],"dc:identifier":["http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353098416"],"dc:language":["English"],"dc:publisher":["University of Cincinnati / OhioLINK"],"dc:rights":["unrestricted","This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws."],"dc:subject":["Epidemiology","Chlamydia trachomatis","Neisseria gonorrhoeae","Preterm Birth","Antenatal Infection","Deterministic Linking"],"dc:title":["Maternal Chlamydia trachomatis and Neisseria gonorrhoeae Infections and the Outcome of Preterm Birth: The Impact of Early Detection"],"dc:type":["Electronic Thesis or Dissertation"],"thesis:degree_discipline":["Medicine: Epidemiology (Environmental Health)"],"thesis:degree_level":["doctoral"],"thesis:degree_name":["PhD"],"thesis:institution_name":["University of Cincinnati"]},"updated_at":"2026-07-24T03:36:23Z"}