{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:48:08Z","timestamp":1792133288323,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the impact of screening and treating asymptomatic pregnant women for <jats:italic>Chlamydia (C.) trachomatis<\/jats:italic> and <jats:italic>Neisseria (N.) gonorrhoeae<\/jats:italic> infections on the frequency of preterm birth or low birthweight infants in Botswana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Non\u2010randomised, cluster\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Four antenatal care clinics in Gaborone, Botswana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Pregnant women aged \u226515\u2009years, attending a first antenatal care visit, \u226427\u2009weeks of gestation and without urogenital symptoms were eligible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants in the intervention clinics received screening (GeneXpert\u00ae, Cepheid) during pregnancy and at the postnatal visit. Participants in the standard\u2010of\u2010care clinics received screening at the postnatal visit only. We used multivariable logistic regression and post\u2010estimation predictive margins analysis. Post\u2010hoc analysis was conducted among sub\u2010samples stratified by parity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Preterm birth (&lt;37\u2009weeks of gestation) and low birthweight (&lt;2500\u2009g).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After controlling for parity, hypertension, antenatal care visits and clinic site, the predicted prevalence of preterm birth or low birthweight was lower in the intervention arm (11%) compared with the standard\u2010of\u2010care arm (16%) (adjusted odds ratio [aOR] 0.59; 95% confidence interval [CI] 0.28\u20131.24). In post\u2010hoc analysis, the intervention was more effective than the standard\u2010of\u2010care (aOR 0.20; 95% CI 0.07\u20130.64) among nulliparous participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A <jats:italic>C.\u2009trachomatis<\/jats:italic> and <jats:italic>N.\u2009gonorrhoeae<\/jats:italic> infection screening and treatment intervention among asymptomatic pregnant women may have reduced preterm birth or low birthweight outcomes, but results were not statistically significant. Post\u2010hoc analysis found that the intervention reduced adverse outcomes among nulliparous participants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17775","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T06:59:05Z","timestamp":1707893945000},"page":"1259-1269","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluating <i>Chlamydia trachomatis<\/i> and <i>Neisseria gonorrhoeae<\/i> screening and treatment among asymptomatic pregnant women to prevent preterm birth and low birthweight in Gaborone, Botswana: A secondary analysis from a non\u2010randomised, cluster\u2010controlled trial"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8067-3616","authenticated-orcid":false,"given":"Adriane","family":"Wynn","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Global Public Health University of California, San 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Hansman","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine University of California  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehumile","family":"Ramontshonyana","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Princess Marina Hospital  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lefhela","family":"Tamuthiba","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Princess Marina Hospital  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neo","family":"Ndlovu","sequence":"additional","affiliation":[{"name":"Botswana Harvard AIDS Institute Partnership, Princess Marina Hospital  Gaborone Botswana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa 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