Prevalence of Chlamydia trachomatis, Mycoplasma genitalium, and Neisseria gonorrhoeae infections in a screening program for under‐30‐year‐old pregnant women with a high participation rate in northern Spain (2016–2020)

Abstract

To assess a screening program for sexually transmitted infections (STIs) in under-30-year-old pregnant women, focusing on Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections, which though often asymptomatic, may significantly affect women's health and can be vertically transmitted. Design: Prospective, descriptive, observational study. Setting: Gipuzkoa (Basque Country, Spain). Population: Under-30-year-old pregnant women. Methods: Between 2016 and 2020, cervical samples were taken at first prenatal appointments from 3051 women. STIs were detected by multiplex nucleic acid amplification. Main Outcome Measures: Prevalence of infections by age and geographical origin groups, and screening coverage. Results: The coverage rate was 86% between 2017 and 2020. At least one STI was detected in 5.2% of the under-30-year-olds screened (95% confidence interval [CI]: 4.5%, 6.1%): C. trachomatis in 4%, M. genitalium in 1.3% and N. gonorrhoeae in 0.1%. C. trachomatis and M. genitalium prevalence rates were higher among younger women (7.2% and 2.8%, respectively in under-25-year-olds), while C. trachomatis prevalence in 25-to 30-year-olds was 2.5%. C. trachomatis was more common among Latin American women (9.7% [95% CI: 7.4%, 12.3%] vs. 2.5% [95% CI: 2.0%, 3.2%] in other women). Additionally, analysing samples from 708 pregnant over-30-year-old women with STI risk factors, 1.6% had at least one of the STIs studied. Notably, 20% of all cases had STI-related symptoms or complications during pregnancy. Conclusions: The high coverage achieved, and prevalence, clinical and epidemiological results support the view that the implementation of a screening program across Spain for C. trachomatis in under-30-year-old pregnant women would be both feasible and appropriate.

Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis in prenatal care in the public health system, in a southern city of Brazil

“…The non-detection of NG in the sample (n=0/148) was in line with the prevalence of 1.0% in Brazilian pregnant women [24,39] and 1,2% in Latin America [23]. Populations at risk, such as young women, sex workers and HIV positive people have a prevalence of 0.1%-1.5% [11,45], 3.3% [44] and 0.9% [46], respectively. Even in underdeveloped countries, NG detection rates during pregnancy are between 0.5 and 4.6% [5,23,40], with emphasis only on Papua New Guinea, with a rate 14.2% [22].…”

“…When compared to developed countries such as France, with a prevalence of 2.5% [21], we have a considerably higher rate, but in European pregnant women under the age of 25, CT was found in 7.6% [21] and 18.4% [41], in France and Spain, respectively. Among women who have some risk factor for STI, we have a prevalence of 10.7% in Brazilian women under 25 years old [42], 2.1% in HIV-positive Brazilian women [43], 4% in Spanish women under 30 years old [11] and 9% in female sex workers [44], which was not found when we strati ed risk groups in our sample.…”

“…MG infection rates between 0.7-8.5% [10,12], with numbers ranging from 2.4 to 10% in young pregnant women, risky sexual behavior and low socioeconomic status [10]. In pregnant women under 30 years of age, M. genitalium was found in 1.3% of Spanish women [11] and 2.4% of French women [21].…”

“…Studies have demonstrated a relationship between M. genitalium and poor sexual health, infertility, miscarriage and preterm labor [3,4,8,9], with the risk of preterm labor independent of other STI [2,10]. Adaptations in immune function and physiological changes in the endocervix that occur during pregnancy are highlighted as potential biological pathways for increased risk of genital infections [11]. Cervicitis is underdiagnosed, due to the large number of asymptomatic cases and, therefore, the syndromic approach is awed, especially in developing countries [12].…”