The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Wednesday, May 10, 2006
268

Impact of STD Upon Birth Outcomes

Yuren Tang, STD Division, Bureau of Communicable Disease Control, Massachusetts Department of Public Health, State Lab Institute, 305 South Street, Room 561, Jamaica Plain, MA, USA


Background:
The impact of STD on birth has not been fully assessed.

Objective:
To assess the impact of STD on birth outcomes by matching the Massachusetts (MA) STD and birth registries, with a hypothesis that STD during pregnancy would have a significant effect.

Method:
The MA registry of births to mothers ≤ 25 y.o., 1996-2000 was matched with the MA STD surveillance database. Multiple births were excluded. Neonatal mortality, low birth weight ( < 2,500 g), premature birth ( < 37 weeks), and neonatal stress (Apgar score at 1 minute < 4) were indicators of negative birth outcome.

Result:
66,173 births and 39,067 female STD cases were identified. 7,370 mothers had STD reported with onset prior to labor, with 2,954 (40%) of them during pregnancy. The incidence of reported STD during pregnancy was 5.8% among teens (15-19 y.o.) and 2.7% among those 20-25 y.o, 3.6% for the total. Teen pregnancy (p<0.0001, OR 1.20, 95% C.I. 1.14–1.27) and STD history ( p<0.0001, OR 1.31, 95% C.I. 1.20–1.43) correlated with premature birth, and the effects were additive. Teen pregnancy and STD history also correlated with low birth weight, (p<0.0001, OR 1.44, 95% C.I. 1.35–1.55 and p<0.0001, OR 1.32, 95% C.I. 1.17–1.49, respectively) and the effects were also additive. Teen pregnancy, but not STD history was associated with neonatal stress (p<0.0002, OR 1.22, 95% C.I. 1.10–1.35).

Conclusion:
This study used statewide birth and STD registries applying a reliable matching algorithm. There was a significant association of STD during pregnancy with premature birth and low birth weight, but the impact of STD on birth was not as large as expected. A possible reason for the limited impact of STD is effective screening in prenatal care leading to effective treatment of STD prior to labor.

Implications:
Since many other factors also affect birth. Further study including social-economic characteristics is suggested.