Pregnancy Registry Among Adolescent Girls and Young Women in Rural KwaZulu-Natal, South Africa: STI-Associated Maternal and Neonatal Outcomes, 2022-2025.
South Africa, 2022 - 2025
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Reference ID
AHRI.FD01-01.Fertility.Dataset.v1
Producer(s)
Sweetness Dube, Nompumelelo Mkwanazi, Nqobile Ngoma, Prof. Maryam Shahmanesh, Thetha Nami Ngithethe Nawe Research Group, Data Management Team, KwaZulu-Natal Department of Health
Metadata
Created on
Aug 17, 2026
Last modified
Aug 17, 2026
Identification
Survey ID number
AHRI.FD01-01.Fertility.Dataset.v1
Title
Pregnancy Registry Among Adolescent Girls and Young Women in Rural KwaZulu-Natal, South Africa: STI-Associated Maternal and Neonatal Outcomes, 2022-2025.
Country
| Name | Country code |
|---|---|
| South Africa | ZA |
Abstract
This is a retrospective surveillance system using a pregnancy registry format embedded within the Thetha Nami Ngithethe Nawe Prep Implementation Trial within the Africa Health Research Institute Health (AHRI) and Demographic Surveillance System (HDSS) in uMkhanyakude District, KwaZulu-Natal, South Africa. The surveillance system was designed to generate longitudinal data on the association of laboratory-confirmed sexually transmitted infections among pregnant adolescent girls and young women who participated in the HIV prevention services.
This study merged data from Thetha Nami Ngithethe Nawe is a peer navigator-led HIV prevention and sexual and reproductive health stepped-wedge randomised controlled trial among 15- 30-year-old young people in rural KwaZulu-Natal, South Africa. In this parent study, HIV testing, Prep and ART initiation, STI screening, testing and treatment as well as contraceptives, were rendered through community-based youth-friendly mobile clinics. This pregnancy surveillance system is therefore nested within the Thetha Nami Ngithethe Nawe AGYW cohort, and followed them up for their pregnancy outcomes. It merged comprehensive sociodemographic, behavioural, clinical and laboratory data with pregnancy outcomes data.
The primary exposure includes laboratory-confirmed STIs: Chlamydia trachomatis, Neisseria gonorhea, Trichomonas vaginalis, syphilis, and hepatitis B. Maternal outcomes include miscarriage, preterm birth, low birthweight, premature rupture of membranes, chorioamnionitis, and maternal sepsis. Neonatal outcomes include stillbirth, low birthweight, intrauterine growth restriction, congenital infections, neonatal pneumonia, neonatal sepsis, vertical transmission and neonatal death.
This surveillance system aimed to quantify the STI prevalence, coinfections, and reinfections during pregnancy and describe the maternal and obstetric outcomes among the pregnant AGYW exposed to STIs compared to those without STI exposure, to identify gaps in the antenatal STI diagnosis and treatment pathways and measure the feasibility of conducting a larger scale pregnancy surveillance system in high burden settings.
This study merged data from Thetha Nami Ngithethe Nawe is a peer navigator-led HIV prevention and sexual and reproductive health stepped-wedge randomised controlled trial among 15- 30-year-old young people in rural KwaZulu-Natal, South Africa. In this parent study, HIV testing, Prep and ART initiation, STI screening, testing and treatment as well as contraceptives, were rendered through community-based youth-friendly mobile clinics. This pregnancy surveillance system is therefore nested within the Thetha Nami Ngithethe Nawe AGYW cohort, and followed them up for their pregnancy outcomes. It merged comprehensive sociodemographic, behavioural, clinical and laboratory data with pregnancy outcomes data.
The primary exposure includes laboratory-confirmed STIs: Chlamydia trachomatis, Neisseria gonorhea, Trichomonas vaginalis, syphilis, and hepatitis B. Maternal outcomes include miscarriage, preterm birth, low birthweight, premature rupture of membranes, chorioamnionitis, and maternal sepsis. Neonatal outcomes include stillbirth, low birthweight, intrauterine growth restriction, congenital infections, neonatal pneumonia, neonatal sepsis, vertical transmission and neonatal death.
This surveillance system aimed to quantify the STI prevalence, coinfections, and reinfections during pregnancy and describe the maternal and obstetric outcomes among the pregnant AGYW exposed to STIs compared to those without STI exposure, to identify gaps in the antenatal STI diagnosis and treatment pathways and measure the feasibility of conducting a larger scale pregnancy surveillance system in high burden settings.
Kind of Data
Retrospective longitudinal clinical registry and surveillance data
Unit of Analysis
Individual pregnant AGYW
Version
Version Description
v1.0.0
Scope
Topics
Keywords
Pregnacy registry,Pregnacy surveillance,Sexually transmitted infections,HIV,Prep,ART,Adolecent girls and yung women,AGYW,Maternal outcomes,Pregnancy outcomes,Neonatal outcomes,Antenatal care,Chlamydia,Gonorhea,Syphilis,Hepatitis B,KwaZulu-Natal,South Africa,Thetha Nami Ngithethe NAWE,HDSS
Coverage
Geographic Coverage
This surveillance system was conducted in the uMkhanyakue District in the north of the KwaZulu-Natal Province, South Africa. Participants are residents of the AHRI HDSS setting, which comprises of approximately 40 community clusters that are served by 11 Department of Health Primary Health Clinics and one district hospital.
Universe
The surveillance universe comprises AGYW aged 15 to 30 years who were the Thetha Nami Ngithethe Nawe HIV Prevention and PrEP implementation trial embedded within the AHIR HDSS who became pregnant between 2022 and 2025. Eligible AGYW who consented to data linkage and had traceable Department of Health maternity case records were enrolled in this surveillance system.
Producers and sponsors
Primary investigators
| Name | Affiliation |
|---|---|
| Sweetness Dube | Africa Health Research Institute |
| Nompumelelo Mkwanazi | Africa Health Research Institute |
| Nqobile Ngoma | Africa Health Research Institute; University of Pretoria; University College London |
| Prof. Maryam Shahmanesh | Africa Health Research Institute; University College London; London School of Hygiene & Tropical Medicine |
| Thetha Nami Ngithethe Nawe Research Group | Africa Health Research Institute |
| Data Management Team | Africa Health Research Institute |
| KwaZulu-Natal Department of Health | KZN DoH |
Producers
| Name |
|---|
| Africa Health Research Institute |
Sampling
Sampling Procedure
A purposive sampling approach was used, including all ~300 eligible AGYW pregnancies from the Thetha Nami Ngithethe Nawe PrEP Implementation trial. Records meeting the inclusion criteria with traceable maternity case records were enrolled. Those with not traceable MCR and cannot be linked to AHRI data will be excluded. Accounting for potential missingness, we expected to analyse ~267 minimum records.
Data collection
Dates of Data Collection
| Start | End |
|---|---|
| 2022-01-01 | 2025-12-31 |
Data processing
Data Editing
A unique identifier generated from the HDSS used across all studies in this study frame was used to link the Thenami Ngithehte Nawe implementation database, laboratory STI testing database and the Department of Health MCR. RedCap validation rules were applied to control for outliers, out-of-range, and missing values in key variables. Quality assurance was conducted through the implementation process, the PI and liaising with the data collectors in the field for queries. Personal identifiers will be excluded from analysis and reporting.
Access policy
Access conditions
Access to the data requires accurate completion of the online data access application form accessible on the AHRI Data repository(<https://data.ahri.org/>). Data users are required to abide by the data use conditions stipulated on the application for access to the data. Failure to do so may result in their data access privileges being revoked by the Data Custodian. In order to recognise the effort and intellectual contributions of AHRI investigators in producing and curating the data, users of AHRI data must acknowledge the source of the data and abide by the terms and conditions under which the data is accessed and must cite the dataset in publication using the citation provided as part of this documentation. All analytical datasets published on the AHRI Data Repository are assigned digital object identifier (DOIs) and the DOIs can be found on the Data Repository under Study Description tab - Access policy. AHRI data users are required to always cite the dataset using the relevant DOI.
Citation requirements
Dube, S., Mkwanazi, N., Ngoma, N., Shahmanesh, M., Africa Health Research Institute , & KwaZulu-Natal Department of Health. (2026). Pregnancy Registry Among Adolescent Girls and Young Women in Rural KwaZulu-Natal, South Africa: STI-Associated Maternal and Neonatal Outcomes, 2022-2025 [Dataset]. Africa Health Research Institute.
DOI: https://doi.org/10.23664/AHRI.FD01-01.FERTILITY.DATASET.V1
DOI: https://doi.org/10.23664/AHRI.FD01-01.FERTILITY.DATASET.V1
Metadata production
DDI Document ID
AHRI.FD01-01.Fertility.Dataset.v1
Producers
| Name | Abbreviation |
|---|---|
| Africa Health Research Institute | AHRI |