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Antenatal Screening for Sexually Transmitted Infections to Reduce Preterm Birth or Low Birthweight (Philani Ndiphile
Andrew Medina-Marino1, Chibuzor M Babalola2, Mandisa M Mdingi3
1Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Summary
Antenatal screening for sexually transmitted infections (STIs) like chlamydia, gonorrhea, and trichomoniasis did not improve overall birth outcomes. However, two-time screening significantly reduced preterm births in pregnant women.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Public Health
Background:
- Sexually transmitted infections (STIs) including *Chlamydia trachomatis*, *Neisseria gonorrhoeae*, and *Trichomonas vaginalis* are linked to adverse birth outcomes.
- Most STIs during pregnancy are asymptomatic, complicating detection and management.
- The efficacy of antenatal STI screening in improving maternal and infant health remains an area of investigation.
Purpose of the Study:
- To evaluate the impact of one-time versus two-time antenatal screening and treatment for common STIs on adverse birth outcomes.
- To compare these screening strategies against standard syndromic management in pregnant women.
Main Methods:
- A randomized controlled trial involving pregnant women in South Africa was conducted.
- Participants were assigned to one-time screening, two-time screening, or standard-of-care (syndromic management).
- The primary outcome was a composite of preterm birth or low birthweight; secondary outcomes included individual components.
Main Results:
- Neither one-time nor two-time antenatal STI screening reduced the composite outcome of preterm birth or low birthweight.
- The two-time screening strategy showed a significant reduction in preterm birth (14.5% vs. 18.8% in standard care).
- No significant difference was observed in low birthweight rates across the groups.
Conclusions:
- Routine antenatal screening for *Chlamydia trachomatis*, *Neisseria gonorrhoeae*, and *Trichomonas vaginalis* did not improve the composite adverse birth outcome.
- A two-time screening approach demonstrated a potential benefit by reducing the incidence of preterm birth.
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