STDs in pregnancy: how to prevent and treat
Sexually transmitted infections (STDs) during pregnancy can pose a serious risk to both mother and baby. Some infections can cause complications such as premature birth, premature rupture of membranes, low birth weight, and even congenital infections. That is why early detection, appropriate treatment and prevention from even before conception is essential.
In this article, we explore which STDs are most common in pregnancy, how they're diagnosed, what they mean, and what you can do to protect yourself and your baby.
Which STDs are most common during pregnancy?
Some sexually transmitted infections are more prevalent and concerning in the context of pregnancy. The most common include:
- Chlamydia: can cause eye infections and pneumonia in the newborn.
- Gonorrhea: It is associated with premature rupture of membranes and premature delivery.
- Syphilis: It can cross the placenta and cause congenital syphilis, miscarriage, or stillbirth.
- HIV: It can be transmitted to the baby during pregnancy, childbirth, or breastfeeding.
- Genital herpes: If there is an active outbreak at birth, a cesarean section may be necessary.
- Human papillomavirus (HPV): in rare cases it can affect the baby during delivery.
- Hepatitis B and C: The risk of vertical transmission exists, especially with hepatitis B if adequate immunoprophylaxis is not administered at birth.
STD prevention is key in prenatal care
Risks of STDs in pregnancy for mother and baby
STDs not only affect the mother's health, but they can also have serious consequences for the baby. Among the documented risks are:
- Vertical transmission (from mother to child) during pregnancy, childbirth or breastfeeding.
- Congenital malformations, especially in infections such as syphilis or uncontrolled HIV.
- Preterm birth and low birth weight, as can occur in cases of chlamydia or gonorrhea.
- Neonatal infections, which may require immediate treatment after birth.
According to the U.S. CDC, many STDs can be transmitted to the baby and cause short- and long-term complications, so they recommend early and repeat screening in some cases.
Diagnosis and screening during pregnancy
Clinical guidelines recommend STD testing during the first trimester, especially if there are risk factors (new sexual partners, previous history of STDs, high-prevalence environments, etc.). Some tests that are usually indicated:
- Blood tests for HIV, syphilis, and hepatitis B.
- Vaginal or cervical exudate to detect chlamydia and gonorrhea.
- PCR or culture to confirm genital herpes if there are symptoms.
In some cases, the tests may need to be repeated later in pregnancy. The World Health Organization (WHO) underlines the importance of universal screening in settings where the prevalence of STDs is high.
"Early diagnosis of an STD during pregnancy can make the difference between a healthy delivery and serious neonatal complications."
Safe Treatment During Pregnancy
Many STDs can be treated even during pregnancy, and this is usually safe for the fetus:
- Chlamydia and gonorrhea are treated with antibiotics such as azithromycin or ceftriaxone.
- Syphilis is treated with benzathine penicillin, which is safe in pregnancy and highly effective.
- HIV requires antiretroviral therapy (ART) to reduce the risk of mother-to-child transmission to less than 1%.
- Genital herpes can be controlled with acyclovir or valacyclovir to reduce the frequency and duration of outbreaks.
- Hepatitis B is not treated during pregnancy, but the baby is protected with vaccine and immune globulin at birth.
Adequate and early treatment drastically reduces the risk of transmission to the baby. It should always be followed under the supervision of health professionals.
Prevention: the best strategy
Preventing an STD in pregnancy is much simpler than treating its consequences. Some effective strategies include:
- Constant use of condoms in all sexual relations.
- STD testing before trying to get pregnant (both in the mother and in the partner).
- Avoid unprotected sex with new partners during pregnancy.
- Vaccination against hepatitis B and, in some cases, HPV.
- Follow medical guidelines and attend all prenatal check-ups.
Sex education, communication as a couple and regular medical care are essential in prevention.
What if I already have an STD and I'm pregnant?
In that case, the most important thing is not to panic. Many STDs can be treated or controlled properly. Inform your midwife or gynaecologist as soon as possible, follow the indicated treatment and go for check-ups. The objective will be:
- Treat the infection to protect your health.
- Prevent transmission to the baby.
- Plan the safest type of birth in each case.
Thanks to medical advances, many women with STDs have healthy pregnancies and uncomplicated babies when they receive proper care.
Guidance information