Sexually transmitted diseases (STDs), also referred to as sexually transmitted infections (STIs) are bacterial, fungal or viral infections that are spread through the engagement of sexual intercourse with anyone who has any of the STDs.
These sexual infections many be spread in a variety of sexual activity asides penetrative sex, including all sexual acts involving the mouth, penis, vagina or anus. Many of these STIs can also be transmitted through skin-to-skin contact, blood interactions and needle sharing among other equipment that is used in intravenous drug use. Sexually transmitted diseases are severe illnesses that usually require treatment irrespective of whether the female counterpart is pregnant or not, but in the case of pregnancies, there is a particular need to exercise more care as mothers are not the only one at risk.
Many STDs pose significant threat to the health of mothers and their babies, and while some may be curable, deadly viral infections such as HIV (Human Immunodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome) currently have no cure. Many hospitals and healthcare providers make it a prerequisite to undergo a screening for some STDs at the beginning of the prenatal phase, but mothers will need to be screened at subsequent visits if they have had sexual intercourse with someone who might be infected. Women are advised to refrain from having multiple sexual partners before and during pregnancy, and for pregnant women who have had sex with someone carrying an STI, fast treatment and early diagnosis is key to protecting the unborn child from the transfer of these diseases to the baby’s cells.
With the advancements in the field of medicine, several researches and breakthroughs have been made that will protect babies from acquiring STIs in situations where the mothers may be infected. While we have already established that it is highly possible for pregnant women to get STIs, and equally possible for unborn babies to acquire these STIs from their mothers, several important questions are further detailed below.
STDs may be transmitted to unborn babies in a number of ways. Some of these infections are transferable while the baby is still in the womb of its mother, while others can infect the child as the baby is being delivered. The Human Immunodeficiency Virus (HIV) and syphilis are examples of sexually transmitted infections that can affect the child while still in the mother’s womb while genital herpes and chlamydia are two of the many infections transferable during birth. Each disease or infection may manifest in different ways and be passed through different modes as detailed below:
Passing of the HIV/AIDS STI to unborn babies can occur through the pregnancy period or during child birth. The use of many of the powerful medications developed to reduce the risk of transmission is highly beneficial to the mother to prevent their babies from developing an HIV infection.
The Herpes condition is relatively safe when compared to other STIs, but poses significant challenge when it is time for delivery. The Herpes lesions that may appear on the genitals of the mother are highly contagious and may affect the infant as soon as childbirth begins. The virus is also quite active and may rapidly multiply. The safest option involves a caesarean section to deliver the newborn and prevent the transmission of the Herpes infection.
While the Gonorrhea itself will most likely not be transmitted to the baby, this very popular STD infection can cause vaginal discharges, abdominal pain and/or a burning sensation that is felt while urinating. Pregnant women with untreated Gonorrhea have increased instances of premature delivery or miscarriages, and babies that are born while their mothers still carry this infection may be born blind, with a life-threatening blood or joint infection.
The HPV is the causative infection of the genital warts. The STD is quite common with the genital warts often apparent as a small cauliflower-like cluster that may be accompanied with a burning or itching sensation. For some people with the condition, the treatment may be recommended after delivery, but it is not uncommon to find cases where the HPV and genital warts are influenced by pregnancy hormones that make them grow larger, and as such, block the birth canal, calling for a caesarean section to deliver the baby.
Chlamydia has been associated with increased exposure to premature deliveries and higher risk of miscarriages. If the unborn child or newborn is infected, there may be a case of pneumonia and severe eye infection. Mothers are advised to be retested within three months to ensure that the infection is gone after treatment.
Syphilis can be diagnosed from a syphilitic skin lesion or through blood tests. The STI is easily transmitted to unborn babies and highly likely to cause fatal infections to newborns and babies. Infants that may be affected are often premature, and are prone to developing organ impairments in the eyes, brain, heart, skin, bones, ears and teeth.
Hepatitis B is severe liver infection that is caused by the hepatitis B viral disease. The chances of transmission are as high as 40 percent in pregnant women, and the infection will primarily enter through the placenta. Babies that inherit the Hepatitis B infection may become a lifetime carrier of the disease that will eventually materialize to a liver infection and subsequently death. For Hepatitis B and other STDs, early screening and detection and use of Hepatitis B vaccines can help prevent infection to the unborn baby.
This infection often causes a yellow-green vaginal discharge, pain during sex and when urinating. It is also associated with an increased risk of having a preterm baby, and in rare cases, the baby may get the infection itself during delivery. Mothers are advised to be retested within 90 days of treatment to ensure that the infection has cleared.
The presence of an STD leaves unborn babies prone to many symptoms. These may include:
The transmittable disease may vary in the mode of infection, and may bring about different symptoms in the baby. The transmittable diseases include:
The next section highlights bacterial and viral infections, their manifestations in the mother and baby, means of transfer and control measures.
Bacterial STI’S – These infection are curable | |||
Infection | Risks (M=Mom; B=Baby) | Method of Transfer | Treatment |
M – Can result in ectopic pregnancies and leads to Pelvic Inflammatory Disease (PID), which can cause infertility B – Premature birth, stillbirth, eye infections | Can transfer in the birth canal during delivery | M – Antibiotics approved by OB/GYN B – Antibiotics are given in the eyes to prevent infection | |
M – Can result in ectopic pregnancies and leads to Pelvic Inflammatory Disease (PID), which can cause infertility B – Pneumonia, eye infections, blindness | Can transfer in the birth canal during delivery | M & B – Antibiotics approved by OB/GYN | |
M – Can cause fallopian tube damage B – Premature birth, low birth weight | Can transfer in the birth canal during delivery | M & B – Antibiotics approved by OB/GYN | |
B – Premature birth, low birth weight | Can transfer in the birth canal during delivery | M & B – Antibiotics approved by OB/GYN | |
M – Miscarriage B – Stillbirth, congenital syphilis which can result in mental & physical problems | Can cross the placenta during pregnancy and can transfer in the birth canal during delivery | M & B – Antibiotics approved by OB/GYN can be given to prevent damage to the fetus | |
Viral STI’S – These infections are not curable | |||
Infection | Risks (M=Mom; B=Baby) | Method of Transfer | Treatment |
M – Can lead to genital cancer B – Warts can develop in the baby’s throat which will require surgery M & B – Warts in birth canal can cause complications during delivery | Can transfer in the birth canal during delivery, but very rare | M & B – Wart treatment can occur during pregnancy but has to be approved by OB/GYN | |
M – Can cause significant damage to the liver B – Unless treated within an hour of birth, 90% of babies will be a carrier for life | Can transfer in the birth canal during delivery | B – No cure, but can be prevented with vaccinations | |
M – Severe outbreak in the first trimester can result in miscarriage B – Fetus is at higher risk if herpes is contracted during pregnancy, and can lead to neonatal herpes. | Can transfer in the birth canal during delivery and rarely can cross the placenta during pregnancy | M – No cure, but outbreaks can be treated with oral medication. B – Treatment immediately following birth improves chances of a healthy baby | |
M & B – HIV can develop into AIDS, which is fatal | Can cross the placenta during pregnancy and can transfer in the birth canal during delivery. Also possible to transfer through breastfeeding | M – Antiviral medication is given to reduce symptoms during pregnancy B – Treatment during pregnancy greatly reduces the chance of transmission to the baby | |
Diagnosis by a professional medical practitioner is highly recommended, and in some cases, STDs may be present without symptoms. In other cases, the present symptoms will manifest as:
The availability of treatment options depends on the stage of the pregnancy and the type of infections. STIs such as Chlamydia, Syphilis, Gonorrhoea, Trichomoniasis and Bacterial Vaginosis can be treated and cured with the administration of antibiotics that have been deemed safe to use during pregnancies. Other virus-based infections including Hepatitis B, HIV or Genital Herpes can, however, not be cured. The use of certain anti-viral medication may be of immense benefit alongside other preventive measures to reduce the risk of transmitting the infections to the unborn baby.
Abstinence is the only way to avoid sexually transmitted diseases while pregnant. All forms of vaginal, oral and/or anal sex should be avoided with unsafe partners, but in the cases of people that are sexually active, the following may be done to reduce the chances of getting an infection:
Staying with one sexual partner and abstinence is very vital for pregnant women who are looking to prevent or manage cases of STIs. Early detection also plays a vital role in preventing the transmission of some of these diseases to the unborn babies during the pregnancy or delivery period. If any of the signs of an STI manifests or if you have had unprotected sex with a partner that may be infected, please proceed to visit your doctor for adequate treatment immediately.
Written by Mark Riegel, MD
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