Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and Repeat Infection Among Pregnant Urban Adolescents

Abstract

BACKGROUND Negative maternal and fetal consequences associated with Chlamydia trachomatis and Neisseria gonorrhoeae during pregnancy make diagnosis essential. The CDC recommends routine screening for sexually transmitted infections at the first prenatal visit, and third trimester repeat screening, specifically for C. trachomatis, is recommended for women under age 25 or at increased infection risk. The impact of repeat screening on diagnosis during pregnancy is not well documented among adolescents. METHODS A prospective cohort of 125 pregnant adolescents with at least one prenatal screen for C. trachomatis and N. gonorrhoeae was analyzed. All participants received prenatal care and delivered at one urban teaching hospital in Washington, DC. Screening results were documented for both sexually transmitted infections. Descriptive and univariate analyses were performed to describe disease prevalence. RESULTS Thirty-one percent of pregnant adolescents were diagnosed with either C. trachomatis or N. gonorrhoeae infection during pregnancy. Of the 75% (95/125) of patients who had more than one screening test, 11% (10/95) had a re-infection, and 7% (7/95) had a new infection on repeat testing. Nine percent (9/95) had recurrent C. trachomatis, while 4% (4/95) had a new diagnosis. Three percent (3/95) had recurrent N. gonorrhoeae, while 4% (4/95) had a new diagnosis. Some experienced co-infection at either initial or repeat testing. CONCLUSIONS Screening for C. trachomatis and N. gonorrhoeae is recommended during pregnancy. In this sample of pregnant adolescents, the overall high incidence and recurrence of C. trachomatis and N. gonorrhoeae support CDC screening and re-screening recommendations, regardless of initial test results.

<i>Trichomonas vaginalis</i> and <i>Chlamydia trachomatis</i> Prevalence, Incidence and Associated Factors in Pregnant Adolescents from Belém City, in the Brazilian Amazon

“…Incidence of CT is not a topic addressed in most of the studies, however it is estimated that there were 3 million new cases of CT in 1996 in the United States [1]. The current finding on CT incidence is superior to those found in pregnant [18] and non-pregnant adolescents [8]. Regarding TV incidence, only one case among 98 women at risk could be identified, which is a significantly lower rate when compared to high-risk adult population [30] and to those previously reported in non-pregnant and sexually active adolescents [3] [10].…”

Conventional Agar-Based Culture Method, and Nucleic Acid Amplification Test (NAAT) of the cppB Gene for Detection of Neisseria gonorrhea in Pregnant Women Endocervical Swab Specimens

“…The Centers for Disease Control and Prevention recommend routine screening for sexually transmitted infections at the first prenatal visit, and third trimester repeat screening, is advised for women under the age of 25, or at raised infection risk. Proactive screening and basic treatment of these common cervical infections, especially among those infected with HIV-1 and HSV-2, should be considered for young sexually active women in Communities with a high incidence of HIV/STIs (24, 25). …”

Loop electrosurgical excision procedure and risk of vaginal infections during pregnancy: an observational study

“…This is likely to reflect the high rate of sexually transmitted infections generally in the greater urban St Louis region, and is consistent with other high-risk populations in the USA with a high prevalence of sexually transmitted infections. 19,20 Additionally, because patients have access to clinical care during pregnancy and routine prenatal screening includes testing for infection, we may be capturing otherwise asymptomatic infection. Finally, positivity for human papillomavirus (HPV) is not routinely captured during pregnancy.…”