{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:03:02Z","timestamp":1793314982547,"version":"4.5.0"},"posted":{"date-parts":[[2026,4,21]]},"group-title":"Sexual and Reproductive Health","reference-count":35,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T00:00:00Z","timestamp":1776729600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,4,21]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                    ,\n                    <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                    , and\n                    <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                    are curable sexually transmitted infections (STIs) associated with adverse birth outcomes. Most infections are asymptomatic. Whether antenatal STI screening improves birth outcomes remains uncertain.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    In a randomized three-group trial in South Africa, pregnant women aged 18 years or older were assigned before 27 weeks\u2019 gestation to: (1) screening and treatment for\n                    <jats:italic>Chlamydia trachomatis, Neisseria gonorrhoeae<\/jats:italic>\n                    , and\n                    <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                    at enrollment, with tests-of-cure (One-Time Screening); (2) screening and treatment at enrollment, repeated at 30 to 34 weeks (Two-Time Screening); or (3) Standard-of-Care (Syndromic management). The primary outcome was a composite of preterm birth (&lt;37 weeks\u2019 gestation) or low birthweight (&lt;2500 g), analyzed in the modified intention-to-treat population of participants with live births. Components of the composite outcome were evaluated individually as the main secondary outcomes. The study was registered with ClinicalTrials.gov,\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04446611\">NCT04446611<\/jats:ext-link>\n                    .\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Of 2247 enrolled participants, 1910 had live births. The composite outcome occurred in 22\u00b79% of the One-Time Screening group (risk ratio [RR] 0\u00b799; 95% confidence interval [CI] 0\u00b781\u20131\u00b721), 20\u00b76% of the Two-Time Screening group (RR 0\u00b789; 95% CI 0\u00b772\u20131\u00b709), compared with 23\u00b72% of the Standard-of-Care group. Preterm birth occurred in 18\u00b79% of the One-Time Screening group (RR 1\u00b700; 95% CI 0\u00b780\u20131\u00b726), 14\u00b75% of the Two-Time Screening group (RR 0\u00b777; 95% CI 0\u00b760\u20130\u00b799), and 18\u00b78% of the Standard-of-Care group. Low birthweight occurred in 14\u00b71% of the One-Time Screening group (RR 1\u00b710; 95% CI 0\u00b783\u20131\u00b746), 12\u00b79% of the Two-Time Screening group (RR 1\u00b701; 95% CI 0\u00b776\u20131\u00b735), and 12\u00b78% of the Standard-of-Care group.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interpretation<\/jats:title>\n                  <jats:p>\n                    Neither screening strategy for\n                    <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                    ,\n                    <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n                    , and\n                    <jats:italic>Trichomonas vaginalis<\/jats:italic>\n                    reduced the primary composite outcome of preterm birth or low birthweight, or low birthweight alone. The Two-Time antenatal STI screening strategy, however, reduced preterm birth by 23%.\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.04.15.26350805","type":"posted-content","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T20:30:17Z","timestamp":1776803417000},"source":"Crossref","is-referenced-by-count":2,"title":["Antenatal Screening for Sexually Transmitted Infections to Reduce Preterm Birth or Low Birthweight (Philani Ndiphile Study): A Randomized Three-Group Trial"],"prefix":"10.64898","author":[{"given":"Andrew","family":"Medina-Marino","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3762-1620","authenticated-orcid":false,"given":"Chibuzor M","family":"Babalola","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2795-0343","authenticated-orcid":false,"given":"Mandisa M","family":"Mdingi","sequence":"additional","affiliation":[{"name":"Research Unit, Foundation for Professional Development, East London, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freedom","family":"Mukomana","sequence":"additional","affiliation":[{"name":"Research Unit, Foundation for Professional Development, East London, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4005-3858","authenticated-orcid":false,"given":"Christina A","family":"Muzny","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology, and Parasitology, Louisiana State University Health Sciences, New Orleans, LA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjana MS","family":"Gigi","sequence":"additional","affiliation":[{"name":"Research Unit, Foundation for Professional Development, East London, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunsul","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Low","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remco PH","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Pretoria, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey D","family":"Klausner","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026042600351380000_2026.04.15.26350805v1.1","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2019-053999"},{"key":"2026042600351380000_2026.04.15.26350805v1.2","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2020-054653"},{"key":"2026042600351380000_2026.04.15.26350805v1.3","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.16774"},{"key":"2026042600351380000_2026.04.15.26350805v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(21)00448-5"},{"key":"2026042600351380000_2026.04.15.26350805v1.5","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2021-055057"},{"key":"2026042600351380000_2026.04.15.26350805v1.6","unstructured":"World Health Organization. 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