Updated 6/2024
STIs, or sexually transmitted infections, are a common occurrence amongst the sexually active population. STIs consist of a bacterial or viral illness which a person can contract from having a genital, oral or anal sex with a person who has an STI. Many people dismiss STIs as common infections and treat them with regular antibiotics without realizing the consequences of inadequate treatment or delay in diagnosis. STIs are a serious health hazard and can cause serious adverse effects in a pregnancy.
The most common STIs include:
1. Genital herpes
2. HIV/AIDS
3. Chlamydia
4. Gonorrhea
5. Hepatitis B
6. Syphilis
7. HPV
8. Trichomoniasis
How can an STI infect a fetus during pregnancy?
STIs sometimes can pass through the placenta or even infect the baby during labor and delivery which can, in turn, cause long-term irreversible health effects in the child. If an STI is neglected or not treated properly, it can cause miscarriage, preterm birth, premature rupture of membranes, uterine infection, and even stillbirth.
More info on specific STIs
Gonorrhea:
Diagnosing gonorrhea during pregnancy is relatively easy. Symptoms like burning sensation in the vagina, abdominal pain, and vaginal discharge are common. Most people will have symptoms if they have gonorrhea, but if left untreated, it can lead to miscarriage or even preterm delivery. If a pregnant individual has an untreated infection during labor and delivery, the baby can develop blindness, a life-threatening blood infection, and even joint infection. Treatment is with oral antibiotics.
Chlamydia:
Chlamydia is considered a mild STI and can be treated with oral antibiotics, but can lead to problems in the newborn becomes infected during labor and delivery. Symptoms include vaginal discharge, painful urination and abdominal pain, but most of the time a pregnant individual may have no symptoms at all. Untreated chlamydia during labor and delivery can cause pneumonia in the newborn and eye infection as well. The good news is that it can be easily treated both in the pregnant individual and the neonate.
Trichomoniasis:
The symptoms of trichomoniasis are easy to recognize. Pregnant people with trichomoniasis can have abundant yellowish-green vaginal discharge, itching, and pain during intercourse. If untreated during pregnancy, preterm delivery, premature rupture of membranes and low birth weight may occur, or the infant may be born infected. Treatment is with oral antibiotics.
HIV:
HIV can be passed on to the fetus during pregnancy. The good news is that if a pregnant individual is HIV positive and is routinely taking medications to treat HIV, the chances that the fetus/neonate becomes infected are drastically reduced. The chance that HIV will infect a fetus is greater if the pregnant individual becomes infected during pregnancy. Once acquired, HIV is an incurable disease, but regular therapy with combination drugs during pregnancy can prevent the disease from passing to the fetus. Treatment is with various oral antiretroviral medications.
Hepatitis B:
Hepatitis B is a viral infection of the liver. Nowadays, most people are vaccinated during childhood. However, if pregnant individual has Hepatitis B before pregnancy or contracts it during pregnancy, the fetus may become infected. If the infection does reach the fetus, the child will likely be affected lifelong. All pregnant persons are screened for Hepatitis B and are encouraged to get the vaccination if they have not already done so.
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Herpes (HSV)
All pregnant individuals should be asked if they have a history of HSV on entry to prenatal care. If they do have a history, more information will be needed on their last outbreak and where the lesions typically occur. This is particularly important at the time of admission for delivery.
Syphilis:
The diagnosis of syphilis is made through a blood test. All pregnant individuals are screened for syphilis during pregnancy. The symptoms of syphilis vary and can range from mild to severe. In fact, the symptoms may be so mild that diagnosis can be delayed. The chances of syphilis being passed to the fetus is high if the pregnant individual remains untreated. Syphilis can lead to premature birth, miscarriage, stillbirth, or infection in the newborn. If a neonate is born infected with syphilis, the baby’s brain, eyes, heart, ears, skin, teeth and bones may be affected. Treatment is with intravenous antibiotics during pregnancy.
Genital Warts:
Genital warts are one of the most common STIs. Symptoms of HPV (the virus that causes genital warts) or genital warts include cauliflower-like clusters formation on the vulva, perineum or vagina which can either itch or burn. During pregnancy, there are some forms of treatment available, but most of the time treatment is delayed until after delivery unless the genital warts become problematic. During pregnancy, the size and number of genital warts may increase due to increased levels of hormones. There are various forms of treatment available.
If you find yourself experiencing symptoms, consult your doctor as soon as possible since your child’s health may be affected. Stay aware, educated and stay healthy!
Additional resources:
Chlamydia, Gonorrhea and Syphilis, ACOG FAQs