STDs and the Risk of Miscarriage, Stillbirth, and Preterm Birth

The Risk to Pregnancy of Sexually Transmitted Diseases

Having a sexually transmitted disease (STD) during pregnancy can bring an increased risk of miscarriage, stillbirth, preterm delivery and many other problems. Without treatment, you may also pass an infection on to your baby in the womb or during labor. The exact risk varies by the type of STD and how under control it is during the pregnancy, along with other factors.

If you have an STD, or if you're worried that you might, talk to a healthcare provider. With the proper treatment, STDs can be managed during pregnancy to reduce or eliminate the risks.

Read on to learn about the effects of different STDs such as syphilis, gonorrhea, herpes, hepatitis, and bacterial vaginosis on pregnancy risks.

Syphilis and the Risk of Miscarriage

doctor checking pregnant woman's abdomen
Risk to pregnancy caused by sexually transmitted diseases. Keith Brofsky/Photodisc/Getty Images

All women should be tested for syphilis during pregnancy (a VDRL test) because it can have very serious outcomes on the pregnancy and the baby. Syphilis increases the risk of:

  • Miscarriage
  • Stillbirth
  • Death of a newborn shortly after birth

Pregnant women with syphilis are treated with penicillin to prevent mother-to-child transmission of this STD.

It's important to understand that there are several stages to syphilis, and a woman may not necessarily know that she is infected.

HIV and Pregnancy

HIV, the virus which causes AIDS, can lead to miscarriage and stillbirth, but by far the greatest concern is that the infection can be passed on the the baby.

In the past, an expectant mother with HIV had a big risk of transmitting the virus to her baby during pregnancy or labor. But with today's highly effective drugs, HIV-positive women who are being properly treated have an excellent chance of preventing mother to child transmission of HIV. The use of antiretroviral therapy (ART) can now prevent transmission around 98 percent of the time.

All women should be tested for HIV in early pregnancy regardless of whether they have risk factors. Pregnancy outcomes are best if a woman's HIV is well-controlled with antiviral medications while she's carrying her baby.

Viral Hepatitis

The risk of viral hepatitis during pregnancy varies by the type of hepatitis. The viral strains common in the U.S. do not increase risk of miscarriage, but viral hepatitis in the mother can pose risks for the baby if it becomes infected in the womb or during labor.

Hepatitis B and, much less commonly, hepatitis C can be passed from mother to baby during pregnancy. Because of serious health concerns, all newborns should be vaccinated against hepatitis B, regardless of whether or not the mother is known to be infected. Babies born to mothers with hepatitis B must get the vaccine within 12 hours of birth, along with a treatment called immune globulin, to prevent a chronic hepatitis infection.

Chronic hepatitis B infection does not often cause symptoms in newborns, but long term chronic infections are a significant cause of both cirrhosis and liver cancer.

Herpes

Genital herpes carries a risk of:

Babies can acquire herpes from the mother if she contracts the infection during pregnancy or if active lesions are present at birth and the baby is delivered vaginally.

If you have genital herpes, you may be prescribed an antiviral medication called Zovirax® Injection (acycloguanosine) during your last month of pregnancy to prevent an outbreak around the time your baby will be born.

Mothers with active lesions often need to deliver by C-section to avoid the risk of mother-baby transmission.

Learn more about how to handle herpes during pregnancy.

Bacterial Vaginosis

Bacterial vaginosis (BV) is an infection of the vagina caused by an overgrowth of certain types of bacteria. It is not strictly a STD, but it is associated with having multiple sex partners or having a new partner. (It also ups the chances of contracting certain STDs.) Bacterial vaginosis increases the risk of pregnancy problems including:

Fortunately, BV is easily treated in pregnancy with antibiotics. BV is not part of normal prenatal testing, so tell you doctor if you might have symptoms. Common symptoms include an unpleasant "fishy" odor and itching or burning of the labia.

Gonorrhea

Untreated gonorrhea increases the risk of several problems in pregnancy:

If gonorrhea is passed to the baby during birth, it may result in dangerous infections.

Your doctor will check you for gonorrhea during an early prenatal visit. Antibiotics can resolve the infection if it is present.

Other STD's and Pregnancy

The STD's listed here are not the only ones which can cause problems in pregnancy. Infections including Chlamydia and more can result in complications. If you have had an STD or feel you are at risk, talk to your doctor, and ask if you need further testing.

Sources:

Ambia, J., and J. Mandala. A Systematic Review of Interventions to Improve Prevention of Mother-to-Child HIV Transmission Service Delivery and Promote Retention. Journal of the International AIDS Society. 2016. 19(1):20309.

Centers for Disease Control and Prevention. STDs During Pregnancy – CDC Fact Sheet (Detailed). Updated 02/11/16. https://www.cdc.gov/std/pregnancy/stdfact-pregnancy-detailed.htm

Rac, M., Revell, P., and C. Eppes. Syphilis During Pregnancy: A Preventable Threat to Maternal-Fetal Health. American Journal of Obstetrics and Gynecology. 2016 Dec 9. (Epub ahead of print).

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