Sexually transmitted infections: Prevalence and clinical outcomes among pregnant women in Western Sydney

• Published in: International journal of gynecology and obstetrics 2024-07, Vol.166 (1), p.107-114
• Main Authors: Ju, I., Elhindi, J., Hook, M., Melov, S. J., Sawleshwarkar, S., Yapa, H. M., Zablotska, I., Pasupathy, D.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; chlamydia; Chlamydia Infections - epidemiology; Female; gonorrhea; Gonorrhea - epidemiology; Humans; Infant, Newborn; Logistic Models; New South Wales - epidemiology; Pregnancy; Pregnancy Complications, Infectious - epidemiology; Pregnancy Outcome - epidemiology; Premature Birth - epidemiology; Prenatal Care - statistics & numerical data; Prevalence; Retrospective Studies; Risk Factors; Sexually Transmitted Diseases - epidemiology; sexually transmitted infections; Stillbirth - epidemiology; syphilis; Syphilis - epidemiology; Young Adult
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.15548

Objective We report the prevalence, characteristics and clinical outcomes of women with sexually transmitted infections (STIs) in pregnancy in the Western Sydney Local Health District (WSLHD) serving a large culturally and socio‐economically diverse community in New South Wales (NSW), Australia, over the last 10 years. Methods A retrospective cohort study of all pregnant women booked for antenatal care at three hospitals in WSLHD between September 2012 and August 2022 inclusive. Characteristics and birth outcomes associated with STIs diagnosed in pregnancy (chlamydia, gonorrhea, and syphilis) are reported using multivariable logistic regression adjusting for relevant confounders. Results During 2012–2022, there were 102 905 births and 451 women (0.44%) with an STI diagnosis during pregnancy. The number of women with a history of chlamydia prior to their current pregnancy has increased over the last 10 years (P 30 (aOR 1.73, 95%CI 1.37–2.19), and those who smoked (aOR 2.24, 95% CI 1.71–2.94) and consumed alcohol (aOR 3.14, 95% CI 1.88–5.23) and illicit drugs (aOR 2.10, 95% CI 1.31–3.36). STIs in pregnancy were borderline associated with stillbirth (aOR 2.19 95% CI 0.90–5.36) but did not have a significant impact on preterm birth (aOR 1.21, 95% CI 0.87–1.68), admission to neonatal intensive care unit (NICU) (aOR 1.02, 95% CI 0.77–1.34), or having a small‐for‐gestational‐age (SGA) baby (aOR 0.97, 95% CI 0.74–1.27). Conclusions Sociodemographic factors such as age, weight, smoking, and alcohol and drug use, were associated with the STI incidence in pregnancy. While the latter did not have an impact on preterm birth, NICU admission, and SGA in our cohort, there was a borderline association with stillbirth. Future research should identify barriers and facilitators to testing in a multicultural population and understanding the drivers of higher rates of STIs in certain population groups. Synopsis We identified sociodemographic factors associated with a higher risk of testing positive for STIs in pregnancy. STI in pregnancy was borderline associated with stillbirth.