Sexually Transmitted and Blood-Borne Infections in Pregnant Women and Adverse Pregnancy Outcomes.

Abstract

To analyze risk factors for the presence of sexually transmitted and blood-borne infections (STBBIs) in pregnancy and to determine whether pregnant women with STBBIs are more likely to experience adverse pregnancy outcomes. This retrospective cohort study involved analyzing the electronic records of 3460 pregnant women followed at Sainte-Justine Hospital in Montréal, Québec, between March 2017 and January 2019. An outcome is defined as a pregnancy where the woman has at least one positive laboratory result for chlamydia, gonorrhea, syphilis, hepatitis B, or hepatitis C (i.e., has one or multiple STBBIs). We performed a logistic regression analysis to determine adjusted odds ratios (aORs) for the risk factors of STBBIs in pregnant women. We identified 84 positive STBBI cases, an overall prevalence of 2.4% (95% CI 1.9-2.9). A logistic regression analysis showed the following factors to be significantly associated with the presence of STBBIs in pregnancy: age <20 years (OR 4.75; 95% CI 1.89-11.96), age 20-29 years (OR 2.38; 95% CI 1.37-4.14), Afro-Caribbean origin (OR 4.12; 95% CI 1.83-9.27), other non-Caucasian origin (OR 2.38; 95% CI 1.20-4.70), and history of STBBIs (OR 2.33; 95% CI 1.02-5.36). STBBIs were not significantly associated with social and material deprivation indices nor were they associated with low birth weight or preterm birth. This study shows age <20 years, age 20-29 years, Afro-Caribbean or other non-Caucasian origin and history of STBBIs to be risk factors for the presence of STBBIs in pregnancy. These results will allow us to propose interventions to reduce STBBIs in women with common risk factors as part of a comprehensive approach to perinatal care.