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

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
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
background
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
background4
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

chlamydia rates among females 1996 2005
Chlamydia Rates among Females: 1996 – 2005

Data Source: CDC (US), FL Dept. of Health (Miami-Dade and Florida)

gonorrhea rates among females 1996 2005
Gonorrhea Rates among Females: 1996 – 2005

Data Source: CDC (US), FL Dept. of Health (Miami-Dade and Florida)

infectious primary and secondary syphilis rates among females 1996 2005
Infectious (Primary and Secondary) Syphilis Rates among Females: 1996 – 2005

Data Source: CDC (US), FL Dept. of Health (Miami-Dade and Florida)

methods
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

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Results

Data Source: Miami-Dade County Health Department

slide10

p-value <.001

p-value <.001

p-value = .0147

Data Source: Miami-Dade County Health Department

slide11

p-value <.001

p-value <.001

p-value <.001

Data Source: Miami-Dade County Health Department

slide12

p-value <.001

p-value <.001

p-value <.001

Data Source: Miami-Dade County Health Department

slide13

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

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p-value = .0841

p-value = .0029

p-value = .0012

Data Source: Miami-Dade County Health Department

conclusions
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
limitations
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