Obstetrics & Gynecology · Infectious Disease · 2 h ago
Repeat Antenatal STI Screening Reduced Preterm Birth, but Not the Primary Outcome
In the Philani Ndiphile randomized three-group trial, 2,247 pregnant women were assigned to one-time screening, repeat screening, or standard syndromic care for three sexually transmitted infections. Neither screening strategy significantly reduced the composite of preterm birth or low birthweight; repeat screening was associated with fewer preterm births, a secondary outcome.
- Neither strategy reduced the primary composite outcome.
- Repeat screening was associated with fewer preterm births.
- Low birthweight rates were similar across groups.
- The preterm-birth finding was a secondary outcome.
The trial (NCT04446611) enrolled pregnant women aged 18 years or older before 27 weeks’ gestation. Participants were assigned to screening and treatment for chlamydia, gonorrhea, and trichomoniasis at enrollment, with tests of cure; the same strategy repeated at 30–34 weeks; or standard care based on syndromic management. The primary outcome was preterm birth before 37 weeks or low birthweight below 2,500 g. Of 2,247 participants, 1,910 had live births.
The composite outcome occurred in 22.9% of the one-time screening group, 20.6% of the repeat-screening group, and 23.2% of the standard-care group. Neither screening strategy significantly reduced the composite. Preterm birth occurred in 14.5% with repeat screening versus 18.8% with standard care (RR 0.77; 95% CI 0.60–0.99); the one-time strategy showed no reduction. Low birthweight rates were similar across groups.
The repeat-screening result suggests a possible benefit for preterm birth, but the primary composite outcome was not reduced, and the preterm-birth finding was a secondary outcome. The supplied abstract does not provide further information on setting or study limitations, so applicability beyond the trial population cannot be assessed here.
In practice
For pregnant women screened before 27 weeks, this trial found that repeating screening and treatment for chlamydia, gonorrhea, and trichomoniasis at 30–34 weeks did not significantly reduce the primary composite of preterm birth or low birthweight compared with syndromic care. Preterm birth, a secondary outcome, was lower with repeat screening (14.5% vs 18.8%; RR 0.77, 95% CI 0.60–0.99), while one-time screening showed no reduction. This result alone does not establish a practice change; the primary outcome was negative, and the supplied abstract does not detail setting or other limitations.
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Clinical Infectious Diseases: Antenatal Screening for Sexually Transmitted Infections to Reduce Preterm Birth or Low Birthweight (Philani Ndiphile Study): A Randomized 3-Group Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.