Sexually transmitted diseases (STDs) are infections primarily spread through sexual contact. These infections can affect anyone, and pregnancy does not offer protection. Understanding their potential impact during pregnancy is important, as STDs pose unique considerations for both the pregnant individual and the developing fetus.
Understanding STD Effects on Pregnancy
Untreated STDs can lead to complications for the pregnant individual, such as early labor, premature rupture of membranes, or uterine infection after delivery. They can also cause chronic conditions like pelvic inflammatory disease, impacting future reproductive health.
Vertical transmission, where the infection passes from the pregnant individual to the fetus or newborn, is a concern. This can occur during pregnancy via the placenta, during birth, or less commonly, after birth. Consequences for the baby include low birth weight, premature birth, developmental issues, stillbirth, neurological damage, or infant death.
Specific STDs and Their Unique Pregnancy Considerations
Specific STDs present distinct concerns during pregnancy, with varying impacts depending on the infection type and whether detected and treated.
Syphilis
Untreated syphilis can lead to congenital syphilis in the baby. This can result in miscarriage, stillbirth, preterm birth, or low birth weight. Babies born with congenital syphilis may appear healthy at birth but can develop issues such as deformed bones, anemia, enlarged liver and spleen, jaundice, or neurological problems like blindness or deafness, sometimes years later.
Human Immunodeficiency Virus (HIV)
Human Immunodeficiency Virus (HIV) can be transmitted from a pregnant individual to their baby during pregnancy, childbirth, or through breastfeeding. Without intervention, there is a substantial chance of the baby becoming infected. However, antiretroviral therapy (ART) taken throughout pregnancy, during childbirth, and by the baby after birth can significantly reduce the risk of transmission to less than one percent.
Gonorrhea and Chlamydia
Gonorrhea and Chlamydia are bacterial infections that can be passed to the baby during vaginal delivery. If untreated, gonorrhea in pregnancy can increase the risk of miscarriage and premature birth. For the newborn, these infections can cause eye infections, known as ophthalmia neonatorum, which can lead to blindness if not treated. Chlamydia can also lead to pneumonia in infants, typically a few weeks to several months after birth.
Herpes Simplex Virus (HSV)
Herpes Simplex Virus (HSV) transmission to the newborn, known as neonatal herpes, is a concern, particularly if the pregnant individual acquires a primary infection late in pregnancy or has active genital lesions at the time of delivery. Neonatal herpes can result in widespread infection affecting major organs, brain damage, or death, as the newborn’s immune system is still developing. A primary HSV infection early in pregnancy may also lead to miscarriage.
Hepatitis B Virus (HBV)
Hepatitis B Virus (HBV) is primarily transmitted from a pregnant individual to the newborn at the time of birth, rather than during pregnancy itself. This vertical transmission is a leading cause of chronic HBV infection in children, which can lead to liver complications later in life. The risk of transmission is higher when the pregnant individual has a high viral load.
Protecting Maternal and Fetal Health
Proactive measures and medical interventions protect both the pregnant individual and the developing baby from STDs. Early and regular screening for STDs during pregnancy is a primary step. Healthcare providers recommend screening for infections like HIV, syphilis, chlamydia, and gonorrhea at the first prenatal visit. Repeat testing may be advised in the third trimester for individuals at increased risk, such as those under 25 or with new or multiple partners.
Many STDs can be safely and effectively treated during pregnancy. Bacterial STDs like chlamydia, gonorrhea, and syphilis can be cured with antibiotics that are considered safe for use during pregnancy. For viral STDs such as HIV and herpes, while there is no cure, antiviral medications can manage the infection, reduce symptoms, and significantly lower the risk of transmission to the baby. For instance, antiviral medication for HSV may be given in late pregnancy to prevent outbreaks near delivery, and a cesarean section may be recommended if active lesions are present.
Prevention strategies also play a role in safeguarding health during pregnancy. Using barrier methods like condoms consistently and correctly during sexual activity can reduce the risk of acquiring STDs. Open communication with healthcare providers about sexual history and any potential exposures allows for timely testing and appropriate management. Discussing sexual health with partners and encouraging them to get tested can also help create a safer environment.