Interactive effects of bacterial vaginal colonization and HIV on pregnancy outcomes: A Systematic Review and Meta-analysis
Bibliographic record
Abstract
Background: HIV and lower genital tract bacterial colonization independently have documented associations with pregnancy outcomes, which is compounded by rapidly escalating antimicrobial resistance. Objectives: To determine interactive effects of HIV and bacterial colonization on low birthweight and preterm birth. Search Strategy: To identify relevant studies, we systematically searched databases (Medline, Embase, CINAHL, Scopus, Web of Science, Cochrane Library, and African Journals Online) from inception until December 2023. Selection criteria: we included observational studies that reported on pregnancy outcomes stratified by vaginal colonization and HIV status. Data collection and analysis: Meta-analysis was conducted using random-effects modelling, reported as pooled log-odds ratios. Main results: We included 13 studies in which 5,807 were identified. The pooled prevalence of bacterial colonization was 26%(95%CI:17.3-37.4). There was no significant effect of HIV status and vaginal colonization on birth weight(OR:1.2; 95%CI: −2.57, 2.20) but borderline increased odds of preterm birth(OR:2.64; 95%CI:−0.01,1.94, p =0.05). There were no significant associations between HIV and bacterial colonization(OR:1.08; 95%CI:−0.91,1.07) nor in antimicrobial resistance between pregnant women with HIV and those without. Conclusions: Bacterial colonization is prevalent among pregnant women, but there is no clear evidence to suggest that HIV and lower genital tract bacterial colonization interact to affect birth weight or preterm birth. Research with large sample sizes, strict selection criteria, reliable/valid measurement, and adequate control for confounding variables, with birthweight and gestational age as continuous outcomes, are still needed to provide robust evidence. Funding: NIH-Fogarty International; D43 Research Training Grant to CUHAS and Global Affairs-Canada; Study in Canada Scholarship provided financial support. Keywords: vaginal bacterial colonization, HIV, adverse pregnancy outcomes, preterm birth, low birth weight.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.033 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.020 | 0.044 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".