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Sexually transmitted infections in pregnancy: Prevalence, coinfections, and pregnancy complications
Evelin López-Corbeto1, Victoria González Soler1, Gabriela Tejada2
1Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Departamento de Salud, Generalitat de Cataluña, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Introduction:
Sexually transmitted infections (STIs) during pregnancy can lead to relevant maternal-fetal complications. The role of other microorganisms such as Mycoplasma genitalium in gestational screening remains a matter of debate. In this context, we analyzed the prevalence of STIs and microorganisms considered saprophytes, as well as their association with pregnancy complications.
Methods:
We conducted a longitudinal study including 742 pregnant women during the first trimester (2021-2023). Vaginal samples were tested by PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, and Trichomonas vaginalis. Sociodemographic and clinical-reproductive variables were collected, and pregnancy complications were recorded.
Results:
A total of 56.3% of pregnant women harbored at least one of the microorganisms studied. The overall prevalence of STIs was 4.7%, significantly higher among women aged ≤25 years (15.6%). Overall and ≤25-year prevalence rates were Chlamydia trachomatis 2.0% and 7.8%; Mycoplasma genitalium 2.2% and 7.8%; Neisseria gonorrhoeae 0%; and Trichomonas vaginalis 0.5% and 0%. Coinfection was observed in 31.1% of cases, predominantly involving Ureaplasma parvum (>47%). Of all pregnancies studied, 92 (12.4%) presented complications, mainly miscarriages (50%). No STI was significantly associated with these complications.
Conclusion:
A high prevalence of STIs was observed, particularly among younger pregnant women. Although the findings do not support expanding universal screening, the results endorse maintaining targeted strategies for women aged ≤25 years and highlight the need to further investigate the clinical impact of Mycoplasma genitalium on maternal-fetal health.
Insights
Sexually transmitted infections (STIs) are common in pregnant women, especially those under 25. While STIs were not linked to pregnancy complications in this study, targeted screening for young women is recommended.
Area of Science:
- Reproductive Health
- Infectious Diseases
- Obstetrics
Background:
- Sexually transmitted infections (STIs) during pregnancy pose risks to maternal and fetal health.
- The role of microorganisms like Mycoplasma genitalium in pregnancy complications requires further investigation.
- This study examines the prevalence of STIs and other microorganisms in pregnant women and their association with adverse outcomes.
Purpose of the Study:
- To determine the prevalence of various STIs and other microorganisms in pregnant women.
- To assess the association between these infections and pregnancy complications.
- To evaluate the need for expanded gestational screening protocols.
Main Methods:
- A longitudinal study involving 742 pregnant women in their first trimester.
- Vaginal samples analyzed via PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, and Trichomonas vaginalis.
- Collection of sociodemographic, clinical-reproductive data, and recording of pregnancy complications.
Main Results:
- Over half (56.3%) of pregnant women carried at least one studied microorganism.
- The overall STI prevalence was 4.7%, significantly higher (15.6%) in women aged 25 years or younger.
- No significant association was found between any STI and pregnancy complications, though miscarriages were the most common complication (50% of cases).
Conclusions:
- A high prevalence of STIs exists among pregnant women, particularly younger individuals.
- Current findings do not support universal STI screening during pregnancy.
- Targeted screening for women aged 25 and under is advised, with further research needed on Mycoplasma genitalium's impact.
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