Many pregnant women may not get STD tests

Despite recommendations that pregnant women have tests for certain sexually transmitted diseases, many may not be getting them, a new study suggests.

Researchers found that of nearly 1.3 million U.S. women who had blood work done during pregnancy, only 59 percent were tested for Chlamydia - a common STD that can cause pregnancy complications or be passed on to newborns.

That’s despite the fact that experts generally recommend pregnant women be screened for Chlamydia.

In addition, 57 percent of women in the study were screened for gonorrhea - a test recommended for some pregnant women.

The U.S. Centers for Disease Control and Prevention (CDC) says that all pregnant women should be tested for Chlamydia at their first prenatal visit. The American College of Obstetricians and Gynecologists (ACOG) has said the same since 2007.

As for gonorrhea, the CDC and other groups recommend screening for pregnant women who are at increased risk. That includes women younger than 25 and those living in areas of the country where gonorrhea is common.

Can pregnant women become infected with STDs?
Yes, women who are pregnant can become infected with the same sexually transmitted diseases (STDs) as women who are not pregnant. Pregnancy does not provide women or their babies any protection against STDs. The consequences of an STD can be significantly more serious, even life threatening, for a woman and her baby if the woman becomes infected with an STD while pregnant. It is important that women be aware of the harmful effects of STDs and know how to protect themselves and their children against infection.

How common are STDs in pregnant women in the United States?
Some STDs, such as genital herpes and bacterial vaginosis, are quite common in pregnant women in the United States. Other STDs, notably HIV and syphilis, are much less common in pregnant women. The table below shows the estimated number of pregnant women in the United States who are infected with specific STDs each year.

STDs - Estimated Number of Pregnant Women

Bacterial vaginosis - 1,080,000
Herpes simplex virus 2 - 880,000
Chlamydia - 100,000
Trichomoniasis - 124,000
Gonorrhea - 13,200
Hepatitis B - 16,000
HIV - 6,400
Syphilis - <1,000

“As our study shows, there’s a significant gap between the recommendations and actual practice,” said Dr. Jay M. Lieberman, who is medical director for infectious diseases at Quest Diagnostics Inc. and worked on the study.

Quest is a diagnostic testing provider that operates labs throughout the U.S. The company offers STD testing and funded the new study.

How can chlamydia affect my pregnancy?
Women who have chlamydia during pregnancy tend to have higher rates of infection of the amniotic sac and fluid, preterm birth, and preterm premature rupture of the membranes (PPROM), although prompt treatment may reduce the risk of these problems. Some studies have linked chlamydia to an increased risk of miscarriage, although other studies have found no connection.

An untreated chlamydia infection also makes you more susceptible to HIV and some other sexually transmitted infections (STIs) if you’re exposed to them. It also raises your risk of a uterine infection after you have your baby.

What’s more, if you have a chlamydia infection when you go into labor, there’s a chance that you’ll pass the bacteria to your baby. In fact, up to half of babies born vaginally to mothers with untreated chlamydia (and even some babies born by c-section) will contract the infection.

Between 25 to 50 percent of these babies will develop an eye infection (conjunctivitis) a few days to a few weeks after birth. (The medicated drops or ointments put in your baby’s eyes soon after birth to prevent gonorrheal conjunctivitis don’t prevent chlamydial eye infections.) And 5 to 20 percent of babies who contract chlamydia during delivery develop pneumonia a few weeks to several months after birth.

Although these infections can be very serious, babies who are treated promptly with antibiotics generally do well. Of course, it’s best to get treated before delivery to prevent your baby from becoming infected in the first place.

Since not all pregnant women are advised to have gonorrhea testing, it’s difficult to tell whether the 57-percent rate in this study is appropriate or not, according to Lieberman.

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