A baby can be born with a sexually transmitted infection (STI), a process called congenital or vertical transmission. This happens when an infection passes from a pregnant individual to their child. Medical advancements offer ways to prevent or manage these situations with appropriate care. Understanding transmission pathways is a first step in addressing this health challenge.
Pathways of Transmission
STIs can transfer from a pregnant individual to their baby through distinct pathways and at different developmental stages. One route is during pregnancy, where the infection crosses the placenta to the fetus. Syphilis, for example, transmits this way, infecting the baby in the womb and potentially affecting fetal development before birth.
Another pathway is during birth, known as perinatal transmission. As the baby passes through the birth canal, they can contact infected maternal fluids or lesions. Gonorrhea, chlamydia, and genital herpes are often transmitted this way. This exposure during delivery is a common mechanism for STIs to pass to the newborn.
Transmission can also occur after birth, often through breastfeeding. Human immunodeficiency virus (HIV) can transmit via breast milk. While less common for most STIs, active sores on the breast from herpes or syphilis pose a risk if the infant directly contacts them. However, many STIs like chlamydia and gonorrhea do not transmit through breast milk.
Specific Congenital Infections
Several STIs pose a risk for vertical transmission. Syphilis, caused by Treponema pallidum, can pass to the fetus during pregnancy, leading to severe outcomes if untreated. HIV, a virus that weakens the immune system, can transmit during pregnancy, birth, or breastfeeding. Effective treatments significantly reduce this risk.
Herpes Simplex Virus (HSV) can transmit during vaginal birth if the baby contacts active lesions. While HSV is not in breast milk, active sores on the breast or nipple can directly transmit the virus. Gonorrhea and chlamydia, both bacterial infections, transfer to a newborn during passage through the birth canal.
Hepatitis B and C are viral infections that can also transmit vertically. Hepatitis B most often passes during childbirth, though intrauterine transmission can occur. Hepatitis C transmission mainly happens during birth. Mycoplasma genitalium has been associated with adverse pregnancy outcomes and potential perinatal transmission, though more research is needed on its neonatal effects.
Health Consequences for Infants
Congenital STIs can lead to various health complications for infants, from mild to severe. Untreated syphilis in a pregnant individual can result in miscarriage, premature birth, stillbirth, or death shortly after birth. Surviving infants may experience multiple organ complications, including issues affecting bones, teeth, eyes, and the brain.
HIV infection can compromise the infant’s immune system, making them vulnerable to illnesses. Neonatal herpes simplex virus infection can be severe, causing skin lesions, eye damage, brain damage, or death. Chlamydia and gonorrhea transmitted during birth can cause eye infections (conjunctivitis) and, for chlamydia, pneumonia. Untreated gonococcal eye infections can result in corneal damage and blindness.
Beyond organ impacts, congenital STIs can contribute to broader developmental problems. These include neurological issues, sensory impairments like blindness or deafness, and growth problems such as low birth weight or premature birth. The severity often depends on the specific STI, transmission timing, and early diagnosis and treatment.
Strategies for Prevention and Care
Preventing congenital STI transmission involves proactive steps, starting with comprehensive prenatal care. Routine STI screening during pregnancy allows for early detection of infections like HIV, syphilis, hepatitis B, chlamydia, and gonorrhea. Early diagnosis enables timely treatment for the pregnant individual, reducing transmission risk to the baby.
Safe sex practices, including consistent condom use, are important throughout pregnancy to prevent new STI acquisitions. If an STI is diagnosed, prompt treatment for the pregnant individual is important. Syphilis, for example, can be cured with antibiotics, preventing harm to the baby. For active genital herpes near delivery, a Cesarean section may be recommended to avoid exposing the baby.
For infants born to mothers with certain STIs, immediate medical interventions are often necessary. These include hepatitis B vaccinations shortly after birth, or specific antiretroviral therapies for babies exposed to HIV. Ongoing monitoring and specialized care are also important for infants born with or exposed to STIs to manage health issues and ensure proper development. These strategies protect both the pregnant individual and their child.