Chlamydia and gonorrhea are two sexually transmitted diseases (STDs) that can cause damage to pelvic organs if not treated. A new sty has reported another possible consequence of an infection: stillbirth, preterm birth, or delivering a small for gestational age infant. Australian researchers published the results online on September 4 in the journal September 4 in Sexually Transmitted Infections.
The researchers conducted a study to evaluate the association between prior chlamydia and gonorrhea infections and adverse obstetric outcomes. They analyzed data from the New South Wales Perinatal Data Collection, which collects information on all births in New South Wales. They also reviewed data from the New South Wales Notifiable Conditions Information Management System, which records all diagnoses of notifiable conditions, including gonorrhea and chlamydia. Women who were pregnant for the first time with a single infant from 1999 through 2008 were included in the study. Obstetric outcomes and potential confounders (data that could skew the results) were retrieved from the birth record. A statistical analysis, adjusted for potential confounders, was conducted to estimate the association between a disease notification prior to the birth and adverse birth outcomes: spontaneous preterm birth, small for gestational age, and stillbirth.
The researchers found that among 354,217 women, 3,658 (1.0%) had a prior chlamydia notification; 196 (0.06%) had a prior gonorrhea notification. The majority of notifications (more than 80%) occurred before the estimated conception date. Among these women, 4.1% had a spontaneous preterm birth, 12.1% had a small for gestational age infant, and 0.6% of women had a stillbirth. Among women with a prior chlamydia notification, the risk of spontaneous preterm birth and stillbirth was increased; however, there was no association with small for gestational age. For women with gonorrhea the risk for spontaneous preterm birth was 2.5-fold; the risk for stillbirth was 2.35-fold, and the risk for small for gestational age was 0.98 (no increased risk). Among women with a prior chlamydia diagnosis, the risk of spontaneous preterm birth did not differ between women diagnosed more than one year prior to conception, within the year prior to conception, or during the pregnancy.
The authors concluded that sexually transmissible infections in pregnancy and the preconception period may be important in predicting pregnancy outcomes.
Take home message:
The risk of a STD can be reduced by practicing safe sex and being in a monogamous relationship. Unfortunately, however, a monogamous woman, even if married, can acquire an unwanted gift from her partner. These infections can usually be cleared up with a course of antibiotics; however, resistant strains that require intensive treatment are present.