Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul;166(1):62-70.
doi: 10.1002/ijgo.15529. Epub 2024 Apr 4.

Sexually transmitted infections in pregnancy and adverse pregnancy outcomes: A retrospective cohort study

Vani Govender  1   2 , Dhayendre Moodley  1   2 , Megeshinee Naidoo  2 , Cathy Connoly  3 , Sinaye Ngcapu  2   4 , Quarraisha Abdool Karim  2
Affiliations

Sexually transmitted infections in pregnancy and adverse pregnancy outcomes: A retrospective cohort study

Vani Govender et al. Int J Gynaecol Obstet. 2024 Jul.

Abstract

Objective: There is a high prevalence and incidence rate of asymptomatic sexually transmitted infections (STIs) during pregnancy in adolescent girls and young women in Africa. The association between STIs and pregnancy outcomes in a hyperepidemic HIV setting has not been well described.

Methods: Pregnant women, HIV-1 negative and <28 weeks' gestation at three primary health clinics in KwaZulu-Natal, South Africa were enrolled from February 2017 to March 2018. Vaginal swabs collected at the first and later antenatal visits were stored and retrospectively tested for HSV-2, Trichomonas vaginalis, Chlamydia trachomatis and Neisseria gonorrhoeae at the end of the study. The association between STIs detected at first and later antenatal visits and pregnancy outcome was assessed using multivariable logistic regression models adjusted for maternal age and treatment received for symptomatic STIs.

Results: Testing positive Mycoplasma genitalium at the first antenatal visit was significantly associated with low birth weight (odds ratio [OR] 5.22; 95% confidence interval [CI]: 1.10-15.98). Testing positive for T. vaginalis at the repeat visit was significantly associated with preterm births (OR 2.37; 95% CI: 1.11-5.03), low birth weight (OR 2.56; 1.16-5.63) and a composite adverse pregnancy outcome (OR 2.11; 95% CI: 1.09-4.08). Testing positive for HSV-2 at the repeat visit was also likely associated with experiencing a preterm birth or any adverse pregnancy outcome (OR 3.39; 95% CI: 0.86-13.3) (P = 0.096).

Conclusions: Among predominantly asymptomatic STIs, M. genitalium detected at baseline visit was significantly associated with low birth weight, while T. vaginalis detected at the repeat visit in later pregnancy was significantly associated with preterm birth. Further research is warranted to study the impact of etiological testing of STIs at more than one antenatal visit and empirical treatment on pregnancy outcomes.

Keywords: adverse pregnancy outcomes; pregnancy; repeat screening; sexually transmitted infections.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

REFERENCES

    1. World Health Organization. Adolescent pregnancy 2022. Accessed May 23, 2023. https://www.who.int/news‐room/fact‐sheets/detail/adolescent‐pregnancy
    1. Barron P, Subedar H, Letsoko M, Makua M, Pillay Y. Teenage births and pregnancies in South Africa, 2017–2021 – a reflection of a troubled country: analysis of public sector data. S Afr Med J. 2022;112(4):252‐258.
    1. Jonas K, Crutzen R, van den Borne B, Sewpaul R, Reddy P. Teenage pregnancy rates and associations with other health risk behaviors: a three‐wave cross‐sectional study among south African school‐going adolescents. Reprod Health. 2016;13(1):50. doi:10.1186/s12978-016-0170-8
    1. Mombo‐Ngoma G, Mackanga JR, González R, et al. Young adolescent girls are at high risk for adverse pregnancy outcomes in sub‐Saharan Africa: an observational multicountry study. BMJ Open. 2016;6(6):e011783. doi:10.1136/bmjopen-2016-011783
    1. Govender V, Moodley D, Naidoo M, Connoly C, Ngcapu S, Abdool Karim Q. High incidence of asymptomatic genital tract infections in pregnancy in adolescent girls and young women: need for repeat aetiological screening. Sex Transm Infect. 2023;99:482‐488.

MeSH terms

LinkOut - more resources