Pregnancy and STDs

Sexually transmitted diseases can be very dangerous, especially if a woman is pregnant.  Most infections can pass from a woman to her baby while the baby is growing inside or during birth. These infections can be life threatening for a baby.

YES.  A woman who’s pregnant is at the same risk for getting an STD as a woman who’s not pregnant. If you’re pregnant, protect yourself by not having sex, or use condoms correctly every time you have any kind of sex.  You can also protect yourself by only having sex with a partner who only has sex with you, who you know for sure doesn’t have an STD.
YES.  To make sure her baby is born healthy it is VERY important that a woman be tested for all STDs during her first trimester, and again in her third trimester if a healthcare provider believes she’s at risk. 
And how do they affect the baby?
Pregnant women who have Trichomoniasis may have a baby that is born early or with low birth weight.  Although rare, Trichomoniasis can spread to the baby, causing a respiratory or genital infection.  A baby can be cured with the right antibiotics.
Untreated or incompletely treated chlamydia has been linked to premature birth and can pass to a baby during a vaginal birth. If a baby gets chlamydia during the birth process, it can get an eye infection and sometimes pneumonia (lung infection). A baby can be cured of chlamydia with the right antibiotics. For these reasons, women who are pregnant should be treated and then retested 3-4 weeks after taking antibiotics to be sure the infection is completely gone.
During pregnancy, gonorrhea can increase the risk of miscarriage, stillbirth and premature birth.  Gonorrhea can also pass to a baby during a vaginal birth.  Gonorrhea in a baby usually appears as a bad eye infection (that could lead to blindness) and sometimes pneumonia.  In some cases, a baby’s gonorrhea infection can spread into its bloodstream, causing a life threatening infection.  A baby can be cured of gonorrhea with the right antibiotics.  For these reasons, women who have gonorrhea while pregnant should be treated, have their partner(s) treated, and be retested 3-4 weeks after taking antibiotics to be sure the infection is completely gone.
Syphilis can cause serious problems in pregnancy, including miscarriage or stillbirth (a baby born dead), or severe birth defects.  A baby born with syphilis has a condition called congenital syphilis, which is very serious and life threatening.  Symptoms usually appear within the first 3 to 7 weeks of life, but may not appear for more than 2 years.  Some consequences of congenital syphilis are sores on the skin and/or in the mouth, runny nose, pneumonia, bone inflammation, low birth weight, tooth damage, deafness, facial abnormalities, and blindness.  When proper medical attention is given, the syphilis can be cured with an antibiotic, but the baby may have the consequences of the infection for the rest of its life.
If you’ve ever been told by a doctor that you have HPV and you’re now pregnant, make sure your healthcare provider knows about it and if you’ve had warts or cervical abnormalities.  Managing an HPV infection may be different if you’re pregnant.  Some women find that warts that appear during pregnancy seem to thrive and multiply and break into smaller pieces during pregnancy.  Skin treatments aren’t always a good idea during pregnancy, so if warts appear, a healthcare provider can remove them with an easy procedure.  While you are pregnant you won’t pass an HPV infection to your baby.  However, HPV infection can pass from a woman to her baby during a vaginal delivery, which may cause the baby to develop warts in its throat or voice box.
Rarely, herpes can pass to a baby before birth, but is it is most common during vaginal delivery.  When a baby gets a herpes infection, it’s called neonatal herpes which usually effects a baby’s eyes, skin, and mouth.  Sometimes the infection spreads and affects the brain, lungs, liver, and adrenal glands – this is very serious and can result in death.  There is medicine that can control the infection in a baby, but there is no cure.  If a woman has an active outbreak at the time of delivery, a C-section may be done to protect the baby.  A baby born when a mother is having her first (sometimes called a primary) outbreak has about a 50% chance of getting herpes. But a baby born to a mother having a recurrent outbreak has only about a 5% chance of getting herpes. 
To reduce the risk of passing herpes to your baby, your healthcare provider may ask you to take precautions; including avoiding sexual activity during the last three months of pregnancy with any partners who also have or who may have genital herpes.  Babies who are born to moms with genital herpes should be tested within 2 days after birth to make sure that the baby gets quick medical treatment if the baby has the virus. 
Follow all recommendations made by your healthcare provider. Below, you can see how each type of hepatitis has its own set of risks to a pregnant woman and her baby: 
Hepatitis A (HAV):  There is a risk of passing the virus to a baby, though a baby born with the infection should not have bad complications, and they will not be able to catch this virus ever again.
Hepatitis B (HBV):  A pregnant woman who has HBV or gets it during pregnancy can pass the virus to her baby before it is born.  Babies who are born with HBV or who get it shortly after birth are at high risk for serious health problems, including death.  When the baby is born, healthcare providers will give the baby a couple of shots- one that can give the baby short-term protection from the infection and another that’s the first shot of the HBV immunization series. Learn more about the HBV vaccine.
Hepatitis C (HCV):  Pregnant women who have HCV need to make sure they get the rest, healthy nutrition and fluid intake recommended by their healthcare provider. Pregnant women cannot be given the same HCV medicine that other people get. Healthcare providers will also decide if a C-section instead of vaginal delivery is best for the baby. Once born, the baby will be monitored for any sign of a hepatitis infection. Breastfeeding is usually safe unless nipples are cracked and/or bleeding.
HIV can be passed from a mother to her baby before the baby is born.  The chance that the baby will be infected can be less than 2% if a mother takes medications that fight the virus during her pregnancy.  If a baby is born HIV-positive, it will need to be on medicine for the rest of its life to keep the infection under control.  If the child does not keep taking the medication, they will likely develop AIDS and will get life threatening infections.
Trichomoniasis, chlamydia, gonorrhea, and syphilis can all be treated and cured with medications prescribed by a healthcare provider during pregnancy.  Viral infections such as HPV, herpes, and HIV cannot be cured, but there are steps a woman can take to ensure that these infections are not passed to her baby. Antiviral medications can protect a baby from both HIV and herpes, and delivering the baby by having a c-section can protect a baby from herpes if the mother is having an active outbreak.

 

Clinical review by: Dr. Robert Milligan