Catherine Haggerty | University of Pittsburgh (original) (raw)

Papers by Catherine Haggerty

The Journal of Infectious Diseases, Jan 11, 2012

Background. Toll-like receptors (TLRs) are involved in the innate immune response. We examined wh... more Background. Toll-like receptors (TLRs) are involved in the innate immune response. We examined whether TLR variants are associated with Chlamydia trachomatis infection among women with pelvic inflammatory disease (PID). Methods. We tested whether 18 tagging single nucleotide polymorphisms (tagSNPs) assayed in 4 TLR genes (TLR1, TLR2, TLR4, TLR6) and 2 adaptor molecules (TIRAP, MyD88) were associated with C. trachomatis among 205 African American women with clinically suspected PID from the PID Evaluation and Clinical Health Study. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). An empirical P value of ,.004 was considered significant. Results. Women with PID who carried the TLR4 rs1927911 CC genotype had significantly increased odds of C. trachomatis (OR, 3.7; 95% CI, 1.6-8.8; P 5 .002). The TLR1 rs5743618TT genotype was also associated with C. trachomatis (OR, 2.8; 95% CI, 1.3-6.2; P 5 .008). Conclusions. Among African American women with PID, variants in the TLR1 and TLR4 genes, which may increase signaling, were associated with increased C. trachomatis infection.

Pain Medicine, Dec 1, 2003

Objective. To determine the relationships between low back pain (LBP) frequency and intensity and... more Objective. To determine the relationships between low back pain (LBP) frequency and intensity and self-reported and performance-based physical function in a large cohort of well-functioning older adults. Design. Cross-sectional survey and examination. Setting. Community-based cohort of the Health, Aging, and Body Composition (Health ABC) study. Participants. Participants were 2,766 community-dwelling adults, aged 70-79; 42% were African American, 52% were men. Outcome Measures. 1) Back pain-location, frequency, intensity; 2) Hip and/or knee pain; 3) Body mass index (BMI); 4) Self-reported difficulty doing functional tasks; 5) Lower extremity function, using the battery from the Established Populations for Epidemiologic Studies in the Elderly (EPESE); 6) Self-rated health; 7) Comorbidity; 8) Depressive symptoms, using the Center for Epidemiological Studies-Depression (CES-D) scale. Results. LBP was common (36%), and its frequency/intensity was significantly associated with other pain and comorbidities. In gender-specific models, LBP frequency/intensity was not significantly associated with EPESE performance score after adjusting for age, race, BMI, CES-D score, knee pain, hip pain, and other comorbidities. LBP frequency/intensity, however, was significantly associated with self-reported difficulty with most functional tasks after adjusting for important confounders. Conclusions. Among well-functioning community-dwelling older adults, LBP frequency/intensity was associated with perceived difficulty in performing important functional tasks, but not with observed physical performance. The demonstrated dose-response relationship between pain frequency/intensity and self-reported task performance difficulty underscores the importance of clinical efforts to treat pain without necessarily eradicating it. Additional work is needed to determine whether back pain is associated with a risk for progressive functional decline and loss of inde

American Journal of Epidemiology, 2006

Peripartum hysterectomy is one of the most serious obstetric complications. Most studies of the p... more Peripartum hysterectomy is one of the most serious obstetric complications. Most studies of the procedure have been conducted in single institutions, limiting their ability to provide national incidence estimates. To provide a national estimate of the incidence of peripartum hysterectomy and to examine risk factors for the procedure, we used cross-sectional data for 1998-2003 from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, an annual nationally representative survey of inpatient hospitalizations. A peripartum hysterectomy was identified when hysterectomy and delivery occurred in the same hospitalization. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for maternal and hospital characteristics using logistic regression. During 1998-2003, an estimated 18,339 peripartum hysterectomies occurred in the U.S. (rate ¼ 0.77 per 1,000 deliveries). The rate increased somewhat over the time period from 0.73 in 1998 to 0.82 in 2003 (p-trend ¼ 0.2). Rates varied by delivery type, with the lowest rate among vaginal births without prior cesarean (0.25). In comparison, rates were higher among vaginal births after cesarean (rate ¼ 0.88; OR ¼ 3.0, 95% CI 2.3-4.0), primary cesareans (rate ¼ 1.86; OR ¼ 6.2, 95% CI 5.4-7.1), and repeat cesareans (rate ¼ 2.99; OR ¼ 8.5, 95% CI 7.4-9.7). Rates were also higher among multiple births (rate ¼ 2.22; OR ¼ 1.5, 95% CI 1.2-2.0) compared to singleton births (rate ¼ 0.75). Our results suggest that primary and repeat cesarean births as well as multiple births are independently associated with an increased risk for peripartum hysterectomy. These findings are concerning given the increasing rate of both cesarean and multiple births in the U.S.

Sexually transmitted infections, 2014

Bacterial vaginosis (BV) is a common condition associated with serious complications including pe... more Bacterial vaginosis (BV) is a common condition associated with serious complications including pelvic inflammatory disease (PID). However, the pathogenesis of BV is poorly understood. Toll-like receptors (TLR) are responsible for microbial recognition and elimination through inflammatory responses. TLR variants have been implicated in infectious and inflammatory diseases and may be involved in BV pathogenesis. We conducted a cross-sectional study to determine if TLR variants are associated with BV. Logistic regression was used to test associations between 14 variants assayed in 6 genes (TLR1, TLR2, TLR4, TLR6, TIRAP and MyD88) and BV/intermediate flora among 192 African-American women with clinical PID from the PID Evaluation and Clinical Health (PEACH) Study. Additionally, we examined associations between variants and endometrial BV-associated anaerobes. To account for multiple comparisons a permutated p<0.003 was used to determine statistical significance. African-American wome...

Archives of Pediatrics & Adolescent Medicine, 2011

Setting: A large multicenter randomized clinical trial assessing PID treatment strategies in the ... more Setting: A large multicenter randomized clinical trial assessing PID treatment strategies in the United States. Participants: Eight hundred thirty-one female patients aged 14 to 38 years with a diagnosis of PID. Main Exposure: Adverse longitudinal outcomes were compared in adolescents (Յ19 years) and adults (Ͼ19 years). Outcome Measures: Primary outcome measures included recurrent sexually transmitted infection at 30 days, recurrent PID, chronic abdominal pain, infertility, pregnancy, and times to recurrent PID and pregnancy. Cox proportional hazards modeling was used to examine the effect of young age on times to pregnancy and recurrent PID. Results: Adolescents were more likely than adults to have positive results of sexually transmitted infection testing at baseline and at 30 days. There were no significant group differences in chronic abdominal pain, infertility, and recurrent PID at 35 or 84 months, but adolescents were more likely to have a pregnancy at both time points. Adjusted hazard ratios (95% confidence intervals) also demonstrated that adolescents had shorter times to pregnancy (1.48 [1.18-1.87]) and recurrent pelvic inflammatory disease (1.54 [1.03-2.30]). Conclusion: Adolescents may require a different approach to clinical care and follow-up after PID to prevent recurrent sexually transmitted infections, recurrent PID, and unwanted pregnancies.

Annals of Epidemiology, 2003

Pregnancy Hypertension, 2016

Objectives-To determine if mid-pregnancy circulating immune biomarkers are associated with preecl... more Objectives-To determine if mid-pregnancy circulating immune biomarkers are associated with preeclampsia. Study Design-Nested case-control study of 410 preeclamptic women and 297 normotensive controls with primiparous singleton pregnancies enrolled in the Danish National Birth Cohort. The mean gestational age in our cohort is 16 weeks (range 9-26). Main Outcome Measures-Preeclampsia was defined by blood pressure ≥ 140/90mmHg and proteinuria ≥3g/24h. Serum immune biomarkers included interleukin (IL)-6, IL-6 receptor, IL-4, IL-4 receptor, IL-5, IL-12, IL-2, TNF-α, TNF-β, TNF-receptor, IL-1β, IL-1α, IL-8, IL-10, IFN-γ, IL-18, macrophage migration inhibitory factor, macrophage inflammatory protein, transforming growth factor-beta (TGF-β), and RANTES. Associations with preeclampsia, term preeclampsia

The Journal of Obstetrics and Gynecology of India

Consanguineous marriage (CM) has been linked to spontaneous abortion (SAB), although studies have... more Consanguineous marriage (CM) has been linked to spontaneous abortion (SAB), although studies have largely been cross-sectional and likely underestimated early loss. We aimed to determine the relationships between CM and SAB in a prospective pregnancy cohort study in Telangana State, India. Data from 661 participants aged 15–35 years in the Longitudinal Indian Family hEalth (LIFE) study actively followed for pregnancy and pregnancy loss were analyzed. SAB was classified as early (< 8) or late (8–22) weeks gestation. We used logistic regression to model the relationships between CM, defined by first-cousin marriage, and SAB, adjusted for maternal age. Women in CM were at a modestly increased risk of any (ORadj 1.15, 95% CI 0.69, 1.91) and early (ORadj 2.03, 95% CI 0.85, 4.83) SAB compared to women in non-CM, although results were not statistically significant. There was no relationship between CM and late SAB. Among couples in southern India, there was a modest increase in early but not late SAB among CMs which may be explained by the expected influence of chromosomal abnormalities and lethal homozygous recessive disease on early loss. Pre- and Peri-marital Health Counseling that addresses this risk may be warranted.

Table S2. Infant health outcomes secondary analysis.pdf shows findings after additional adjustmen... more Table S2. Infant health outcomes secondary analysis.pdf shows findings after additional adjustment for infant sex, breastfeeding initiation, and hygiene factors. (PDF 250 kb)

Table S1. Standardized Bias.pdf provides a comparison of standardized bias for pre-delivery mater... more Table S1. Standardized Bias.pdf provides a comparison of standardized bias for pre-delivery maternal variables before and after weighting by the propensity score. (PDF 197 kb)

Circulation

Background: Spontaneous abortion (SAB) is a common early pregnancy complication globally, impacti... more Background: Spontaneous abortion (SAB) is a common early pregnancy complication globally, impacting 15% of clinically recognized pregnancies. The biological pathways leading to SAB are not clearly understood, although early SAB is often attributed to chromosomal abnormalities. Elevated blood pressure (BP) in women of reproductive age predicts cardiovascular disease later in life, but less clear is whether elevated BP during preconception and/or early pregnancy BP elevations can affect prenatal outcomes. Hypothesis: Elevated BP during preconception and the first trimester will be positively associated with SAB. Methods: We conducted a secondary analysis of data collected from 577 primiparous women (15-35 years) who participated in the Longitudinal Indian Family hEalth (LIFE) prospective pregnancy cohort study in Telangana State, India. Resting blood pressure was measured by trained technicians using a standardized study protocol at a preconception registration visit and in the first ...

Sexually Transmitted Diseases

A vaginal 16S rRNA quantitative polymerase chain reaction study demonstrated that Chlamydia trach... more A vaginal 16S rRNA quantitative polymerase chain reaction study demonstrated that Chlamydia trachomatis–positive women who also tested positive for Atopobium vaginae, Sneathia spp., Megasphaera spp., Eggerthella-like bacterium, or Prevotella amnii were at elevated pelvic inflammatory disease risk. Abstract In a vaginal 16S ribosomal RNA gene quantitative PCR study of 17 pelvic inflammatory disease (PID) cases and 17 controls who tested positive for Chlamydia trachomatis, women who additionally tested positive for Atopobium vaginae, Sneathia spp., Megasphaera spp., Eggerthella-like bacterium or Prevotella amnii were more likely to develop PID.

Journal of Epidemiology and Global Health

We sought to identify factors associated with mode of delivery in a peri-urban Indian population ... more We sought to identify factors associated with mode of delivery in a peri-urban Indian population with a high cesarean section rate. Poisson regression with robust error variance was applied to model factors associated with cesarean compared to vaginal delivery in a prospective, preconception pregnancy cohort study in Telangana State, India. Adjusted relative risks and 95% confidence intervals from multivariable models are presented. Among 1164 singleton births between 2010 and 2015, 46% were delivered by cesarean. In multiparous women (n = 674), prior cesarean delivery (4.2, 3.2-5.6), prior twin delivery (1.4, 1.1-1.9), diagnosis of hypertension (1.4, 1.0-2.0), or preeclampsia (3.5, 2.1-5.7) in a prior pregnancy independently increased the risk of cesarean. Prepregnancy overweight/obesity (1.4, 1.0-1.9), a composite of prenatal complications (1.3, 1.0-1.7), a composite of labor complications (1.5, 1.0-2.3), nonreassuring fetal heart rate (2.3, 1.3-4.1), and breech position (2.6, 1.4-5.0) also increased the cesarean risk. Among nulliparous women (n = 233), cephalo-pelvic disproportion (1.9, 1.2-3.0), a composite of labor complications (2.9, 1.8-4.9), and breech position (3.4, 1.9-6.2) increased the risk of cesarean. The high rate of cesarean delivery in this peri-urban Indian population is attributed to history of pregnancy complications, history of prior cesarean, prepregnancy body mass index, and medical indications at delivery.

American journal of reproductive immunology (New York, N.Y. : 1989), Jan 14, 2018

A handful of studies report sexual dimorphism in the maternal angiogenic profile possibly influen... more A handful of studies report sexual dimorphism in the maternal angiogenic profile possibly influencing placental development and preeclampsia risk. This secondary analysis explored associations between fetal sex and soluble fms-like tyrosine kinase-1 (sFLT) and endoglin (9-35 weeks gestation) using data from a nested case-control study within the Danish National Birth Cohort. A total of 448 preeclamptic women and 328 normotensive women had data on sFLT and endoglin. Preeclampsia was defined by blood pressure ≥140/90 mm Hg and proteinuria (≥0.3g or 300 mg/24 h.). Generalized linear models adjusting for gestational age of blood draw, body mass index, maternal age, and smoking determined associations between fetal sex and log-transformed biomarkers. Male fetal sex is associated with 11% lower sFLT levels (β = -0.11, P = 0.03) in preeclamptic women. There were no differences observed in normotensive women. We found no statistically significant differences in endoglin by fetal sex among g...

Pregnancy hypertension, Jan 24, 2018

Small studies suggest that fetal sex alters maternal inflammation. We examined the association be... more Small studies suggest that fetal sex alters maternal inflammation. We examined the association between fetal sex, preeclampsia and circulating maternal immune markers. This was a secondary data analysis within a nested case-control study of 216 preeclamptic women and 432 randomly selected normotensive controls from the Collaborative Perinatal Project. All women had singleton, primiparous pregnancies without chronic health conditions. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for associations between female fetal sex and preeclampsia. Outcomes included preeclampsia, preterm preeclampsia (<37 and <34 weeks), and normotensive preterm birth <37 weeks. Associations between female fetal sex and immune markers [interleukin (IL)-6, IL4, IL5, IL12, IL10, IL8, IL1-beta, interferon (IFN)-gamma, tumor necrosis factor (TNF)-beta, and transforming growth factor-beta] were examined using a statistical method developed for large proportion...

American journal of obstetrics and gynecology, Sep 19, 2017

Chlamydia trachomatis infection is highly prevalent among young women in the United States. Preve... more Chlamydia trachomatis infection is highly prevalent among young women in the United States. Prevention of long-term sequelae of infection, including tubal factor infertility, is a primary goal of chlamydia screening and treatment activities. However, the population attributable fraction of tubal factor infertility associated with chlamydia is unclear, and optimal measures for assessing tubal factor infertility and prior chlamydia in epidemiologic studies have not been established. Black women have increased rates of chlamydia and tubal factor infertility compared to white women, but have been underrepresented in prior studies of the association of chlamydia and tubal factor infertility. To estimate the population attributable fraction of tubal factor infertility associated with Chlamydia trachomatis infection by race (black, non-black), and assess how different definitions of C. trachomatis seropositivity and tubal factor infertility affect population attributable fraction estimates...

Infectious Diseases in Obstetrics and Gynecology, 2016

Background. Infection withChlamydia trachomatis(CT) can lead to reproductive sequelae. Informatio... more Background. Infection withChlamydia trachomatis(CT) can lead to reproductive sequelae. Information on the general population of childbearing age women in India is sparse. We reviewed the literature on CT prevalence within the general population of reproductive aged women in order to improve the efforts of public health screening programs and interventions.Objective. To conduct a literature review to determine the prevalence ofChlamydia trachomatisamong childbearing age women in India.Search Strategy. Ovid Medline and PubMed databases were searched for articles from January 1, 2003, through December 31, 2014. Search terms included “Chlamydia trachomatis”, “CT”, “prevalence”, “India”, and “sexually transmitted infections”.Selection Criteria. Studies on prevalence data for CT among women of childbearing age (15–45) living in India were included.Data Collection and Analysis. Articles that met the inclusion criteria were extracted by two readers and discrepancies solved through discussio...