STIs can cause damage to uterus, premature birth, say gynaecologists
Gynaecologists and Obstetricians have warned that exposure to sexually transmitted infections if not well treated can increase the chance of premature birth, miscarriage and premature rupture of membranes.
The reproductive experts noted that STIs like chlamydia, gonorrhoea, and syphilis are all known to cause other complications like low birth weight, and stillbirth and can damage the uterus.
The World Health Organisation described preterm as babies born alive before 37 weeks of pregnancy.
WHO noted that babies may be born preterm due to spontaneous labour or if there is a medical indication to plan an induction of labour or caesarean birth early.
According to the global health organisation, an estimated 13.4 million babies were born too early in 2020, adding that more than one in 10 babies and approximately 900, 000 children died in 2019 due to complications of preterm birth.
Speaking with PUNCH Healthwise, the gynaecologists noted that pregnant women are vulnerable to STIs, as their immune systems are suppressed to protect the developing foetus.
While stressing that STIs can also have long-term consequences on a woman’s reproductive health, the maternal health experts added that infants born can become infected and develop a life-threatening condition called congenital syphilis.
An obstetrician and gynaecologist, Dr Joseph Akinde said the potential risks of an infection to a mother and baby include severe illness, premature labour, chronic ill health, and damage to major organs of the body, among others.
Dr. Akinde Joseph
Dr. Joseph Akinde
The reproductive health expert, who is a former Chairman of the Society of Gynaecology and Obstetrics of Nigeria, Lagos State chapter, noted that untreated STIs during pregnancy can damage the baby’s brain and heart.
According to him, early detection through clinical examination and tests followed by adequate treatment in early pregnancy are some of the ways to avoid complications of sexually transmitted infections in pregnancy.
He added, “Pregnant women should ensure they let their attending physician know of any strange symptoms like discharge or ulcer in the genital areas so that such symptoms can be investigated and treated adequately as soon as possible
“Sexually transmitted disease can cause a remarkable increase in premature delivery. STIs may lead to complications during and after delivery. Such complications include puerperal sepsis, opthalmic, neonatorum, HIV infection and syphilis in the newborn, and even neonatal death.”
On his part, a Consultant Obstetrician and Gynecologist at Zenith Medical & Kidney Centre, Abuja, Chinedu Obikili, said the complications can range from mild illness and discomfort to intra-uterine fetal death and early neonatal death.
He noted that STIs in pregnant women could also significantly contribute to maternal death.
The reproductive expert explained, “It is important to note that STIs can be bacterial, viral and parasitic. The most problematic ones are HIV, Hepatitis B, Genital Herpes, Syphilis, Gonorrhoea and Chlamydia. There are numerous risks to both the baby and mother, and it varies based on the exact STI that is implicated.”
On how best to treat infection in pregnant women, he advised, “The treatment depends on the type of STI. The treatment choice must be safe for the baby. Viral STIs are generally not curable and treatment aims at reducing the quantity of the virus and severity of the illness
“During pregnancy, the same principles for preventing STIs are maintained, which involves safe sexual practices. Where STIs are diagnosed it is important to treat both the woman and her partner.
“Pregnancy generally lowers a woman’s immunity and she is more likely to be infected by an STI. The viral ones can be particularly problematic as a new infection with HIV for instance increases the risk of transmitting the virus to the baby
“STIs have been associated with preterm delivery and low birth weight by multiple mechanisms. Those that cause a systemic disease in the mother are more likely to result in complications. Some of the ones that act locally can lead to a woman’s water breaking prematurely and that would typically result in a preterm delivery.”
On the long-term complications, Obikili said, “These long-term effects range from eye infections, chest infections to deformities and long-term chronic illness like AIDS.
“It is important that routine antenatal screening be done early in pregnancy and important treatment instituted to minimize these long-term effects.”
Meanwhile, a study published in the Journal of Obstetrics and Gynecology, found that women who had chlamydia or gonorrhoea during pregnancy were twice as likely to give birth prematurely.
The research, which had to do with more than 3,000 women, found that those who had chlamydia during pregnancy were nearly twice as likely to have a preterm birth, and women who had gonorrhoea were more than three times as likely to have a preterm birth.
The study also found that women infected with both chlamydia and gonorrhoea had a five times higher risk of experiencing preterm birth.
The study’s authors suggested that screening for STIs and providing appropriate treatment may help to reduce the incidence of preterm birth.
The Journal of Maternal-Fetal and Neonatal Medicine study looked at a smaller number of women, but it had similar findings.
The study found that women with syphilis were nearly three times as likely to have a preterm birth, and women with gonorrhoea were nearly twice as likely to have a preterm birth.
This study also suggested that treatment of syphilis and gonorrhoea during pregnancy may help to reduce the risk of preterm birth.
