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Prevalence of Sexually Transmitted Diseases in Pregnant Women: Miami-Dade County, 2004-2005

Prevalence of Sexually Transmitted Diseases in Pregnant Women: Miami-Dade County, 2004-2005. Maria Bustamante, MPH, Rodlescia Sneed, MPH, Erin O'Connell, MPH, Guoyan Zhang, MD, MPH, Fermin Leguen, MD, MPH Miami-Dade County Health Department, Florida. Objectives.

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Prevalence of Sexually Transmitted Diseases in Pregnant Women: Miami-Dade County, 2004-2005

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  1. Prevalence of Sexually Transmitted Diseases in Pregnant Women: Miami-Dade County, 2004-2005 Maria Bustamante, MPH, Rodlescia Sneed, MPH, Erin O'Connell, MPH, Guoyan Zhang, MD, MPH, Fermin Leguen, MD, MPH Miami-Dade County Health Department, Florida

  2. Objectives • To explore the prevalence of chlamydia, gonorrhea, and syphilis during pregnancy among women in Miami-Dade County • To examine associations between STD prevalence among pregnant women and age, race/ethnicity, marital status, preterm birth, and low birth weight

  3. Background • Sexually transmitted diseases (STDs) can contribute to a number of adverse pregnancy outcomes • Early onset of labor • Ectopic pregnancy • Stillbirth • Low birth weight • Conjunctival infection of newborn • The CDC 2006 Guidelines for Treatment of Sexually Transmitted Diseases recommend pregnant women be screened for STDs on their first prenatal visit including • Chlamydia – Hepatitis B • Gonorrhea – Hepatitis C • Syphilis – HIV

  4. Background • Chlamydia and gonorrhea • Transmitted during delivery as baby passes birth canal • Syphilis • Transmitted during pregnancy by crossing the placenta and infecting the baby in the uterus • All three (chlamydia, gonorrhea, and syphilis) can be treated and cured during pregnancy with antibiotics • Estimated number of pregnant women in the United States infected each year • Chlamydia 200,000 • Gonorrhea 40,000 • Syphilis 8,000 Data Source: CDC, Division of STD Prevention

  5. Chlamydia Rates among Females: 1996 – 2005 Data Source: CDC (US), FL Dept. of Health (Miami-Dade and Florida)

  6. Gonorrhea Rates among Females: 1996 – 2005 Data Source: CDC (US), FL Dept. of Health (Miami-Dade and Florida)

  7. Infectious (Primary and Secondary) Syphilis Rates among Females: 1996 – 2005 Data Source: CDC (US), FL Dept. of Health (Miami-Dade and Florida)

  8. Methods • Data was obtained from live birth certificates (2004 revision) for calendar years 2004 and 2005 • 64,410 live births • Chi-square test was used to examine associations between STD prevalence among pregnant women and • Maternal characteristics ̶ STDs • age • chlamydia • race/ethnicity • gonorrhea • marital status • syphilis • Newborn characteristics • preterm birth (<37 weeks) • low birth weight (<2,500 grams) Data Source: Miami-Dade County Health Department

  9. Results Data Source: Miami-Dade County Health Department

  10. p-value <.001 p-value <.001 p-value = .0147 Data Source: Miami-Dade County Health Department

  11. p-value <.001 p-value <.001 p-value <.001 Data Source: Miami-Dade County Health Department

  12. p-value <.001 p-value <.001 p-value <.001 Data Source: Miami-Dade County Health Department

  13. Prevalence Rates of Low Birth Weight Infants (<2,500 grams) by Mother's STD Status: Miami-Dade County, 2004-2005 p-value = .0553 p-value = .0031 p-value = .0008 Data Source: Miami-Dade County Health Department

  14. p-value = .0841 p-value = .0029 p-value = .0012 Data Source: Miami-Dade County Health Department

  15. Conclusions • There are clear disparities with respect to age, race/ethnicity, and marital status for STD prevalence during pregnancy • 10-19 years of age • Non-Hispanic Blacks and Haitians • Unwed mothers • The presence of gonorrhea and syphilis during pregnancy can contribute to adverse pregnancy outcomes such as low birth weight and preterm birth. • Increased preconception screening for STDs, especially in high-risk populations, may prove useful • The new “Medical and Health Information” section on the 2004 revision of the live birth certificate concerning infections present and/or treated during pregnancy could be useful tool for studying STDs among pregnant women

  16. Limitations • STDs present and/or treated during pregnancy were reported by physician at time of birth • Mother may have changed providers during pregnancy • Unable to adjust for race/ethnicity when examining prevalence rates of preterm births and low birth weight by mother’s STD status • Small sample size after stratification by race/ethnicity • Unable to evaluate the sensitivity and specificity of birth certificate STD data • Lack of identifiers on STD Surveillance data, unable to link databases

  17. Number of STD Cases Identified by Data Source

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