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Instituto de Higiene e Medicina Tropical

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Sexually transmitted infections in pregnant adolescents: prevalence and association with maternal and foetal morbidity

BACKGROUND:
Pregnant adolescents have a high incidence of sexually transmitted infections and higher risk of adverse birth outcome.

OBJECTIVES:
To assess the prevalence of sexually transmitted infections in pregnant adolescents and the associations between these infections and adverse birth outcome.

METHODS:
A prospective study with a face-to-face interview to pregnant adolescents was followed by first-void urine and cervical swabs collection for polymerase chain reaction testing for Chlamydia trachomatis and Neisseria gonorrhoeae. After child delivery, clinical files were also reviewed for serological and microbiological results for other infections and data concerning maternal-foetal morbidity. A 5% level of significance was used.

RESULTS:
The inclusion criteria were fulfilled by 204 pregnant adolescents, and the prevalence of C. trachomatis was 11.8% and of N. gonorrhoeae was 4.9%, with the majority being asymptomatic. No antibodies for syphilis or human immunodeficiency virus were found. Maternal morbidity occurred in 3.4%, prematurity was observed in 11.8% of the newborns and low birth weight in 9.8%. Statistically significant associations were observed between maternal morbidity and the presence of gonorrhoea, younger adolescents and severe prematurity and between infection with C. trachomatis and/or N. gonorrhoea and low birth weight.

CONCLUSIONS:
Sexually transmitted infections are frequently asymptomatic and cause maternal-foetal morbidity. The opportunity that pregnancy offers for screening and counselling should not therefore be missed, especially in adolescents.

Sexually transmitted infections in pregnant adolescents: prevalence and association with maternal and foetal morbidity

BACKGROUND:
Pregnant adolescents have a high incidence of sexually transmitted infections and higher risk of adverse birth outcome.

OBJECTIVES:
To assess the prevalence of sexually transmitted infections in pregnant adolescents and the associations between these infections and adverse birth outcome.

METHODS:
A prospective study with a face-to-face interview to pregnant adolescents was followed by first-void urine and cervical swabs collection for polymerase chain reaction testing for Chlamydia trachomatis and Neisseria gonorrhoeae. After child delivery, clinical files were also reviewed for serological and microbiological results for other infections and data concerning maternal-foetal morbidity. A 5% level of significance was used.

RESULTS:
The inclusion criteria were fulfilled by 204 pregnant adolescents, and the prevalence of C. trachomatis was 11.8% and of N. gonorrhoeae was 4.9%, with the majority being asymptomatic. No antibodies for syphilis or human immunodeficiency virus were found. Maternal morbidity occurred in 3.4%, prematurity was observed in 11.8% of the newborns and low birth weight in 9.8%. Statistically significant associations were observed between maternal morbidity and the presence of gonorrhoea, younger adolescents and severe prematurity and between infection with C. trachomatis and/or N. gonorrhoea and low birth weight.

CONCLUSIONS:
Sexually transmitted infections are frequently asymptomatic and cause maternal-foetal morbidity. The opportunity that pregnancy offers for screening and counselling should not therefore be missed, especially in adolescents.