Metrics details. Chlamydia trachomatis CT and Neisseria gonorrhoeae NG are extremely common sexually transmitted infections STIs that are associated with adverse birth and neonatal outcomes, and the risk of vertical transmission of CT and NG during delivery is high. The majority of CT and NG infections are asymptomatic and missed by the standard of care in most countries treatment based on symptoms.
Thus, it is likely that missed maternal CT and NG infections contribute to preventable adverse health outcomes among women and children globally. This study aims to assess the effectiveness of CT and NG testing for asymptomatic pregnant women to prevent adverse neonatal outcomes, understand the inflammatory response linking CT and NG infections to adverse neonatal outcomes, and conduct an economic analysis of the CT and NG testing intervention.
The trial will also evaluate immunological and inflammatory markers of adverse neonatal outcomes, as well as the costs and cost-effectiveness of the intervention compared with standard care. The Maduo study will improve our understanding of the effectiveness and cost-effectiveness of CT and NG testing among asymptomatic pregnant women. Further, results from this study could encourage expansion of STI testing during antenatal care in low resource settings and improve maternal and neonatal health globally.
Trial registration : This trial is registered with ClinicalTrials. Peer Review reports. Women are particularly vulnerable to STIs due to increased susceptibility to genital tract infections compared to men [ 4 , 5 ], gender inequalities that can result in decreased power to negotiate sex or condom use [ 6 ], and increased risk for STI-related adverse health outcomes, including pelvic inflammatory disease and sequelae [ 7 , 8 , 9 ].
There is evidence that maternal CT and NG infections are associated with adverse birth and neonatal outcomes [ 13 ], including preterm birth and low birth weight [ 14 , 15 , 16 , 17 , 18 ], miscarriage [ 14 , 17 ], and stillbirth [ 14 , 19 ].
