A new study revealed that teenagers who give birth have a higher-than-expected risk of sexually transmitted infections (STIs) and high rates of preterm births and chorioamnionitis.1

Researchers studied adolescents, ages 13 to 19, who had given birth, to assess their preterm birth rates and prevalence of STIs. Chorioamnionitis, which is associated with an increased risk of infant mortality, has a prevalence of less than 1% in the United States.2 The study’s cohort of adolescents had a 15.2% rate of chorioamnionitis.1

“We found a higher-than-expected preterm birthrate of 18.8%,” says Esther Fuchs, MD, assistant professor of obstetrics and gynecology at UW Medicine, Harborview Medical Center in Seattle.

The overall STI infection prevalence was 16.5%. The teenage cohort had no HIV or syphilis infections, but had infections of Chlamydia trachomatisTrichomonas vaginalis, and Neisseria gonorrhoeae. “The same reason teenagers got pregnant: not having birth control or condom use led to their having STIs,” Fuchs says.

Researchers found a gap in screening that could help prevent chorioamnionitis problems. Pregnant patients, including higher-risk patients such as teenagers, are not screened for trichomoniasis, she says.

“Most gynecologists don’t do this screening,” Fuchs says. “We only screen for gonorrhea and chlamydia.”

While screening for trichomoniasis is an extra expense, it would be helpful to screen teenagers, who are a high-risk group, she says. “I would like providers to add trichomoniasis testing to their existing tests for chlamydia and gonorrhea,” she adds. “Every adolescent who is pregnant is possibly at risk for having an STI. We know teenagers might not be exclusive in their relationships, and that puts them more at risk.”

Family planning centers that give away condoms also are helping to prevent STIs, including trichomoniasis. “Right now, in our clinic, we give out condoms for free and have them available in the clinic’s bathroom, so people can serve themselves,” Fuchs says.

Some pregnant women in the study were treated for an STI, cured, and were tested again later. “Several had another infection during the same pregnancy,” Fuchs says.

“It’s important to know that there’s not enough emphasis on teenage pregnancies here in the United States,” Fuchs says. “Teenagers are at higher risk of preterm birth and STIs.”

REFERENCES

  1. Fuchs E, Dwiggins M, Lokken E, et al. Influence of sexually transmitted infections in pregnant adolescents on preterm birth and chorioamnionitis. Infect Dis Obstet Gyn 2020;1908392. doi: 10.1155/2020/1908392.
  2. Malloy MH. Chorioamnionitis: Epidemiology of newborn management and outcome, United States 2008. J Perinatol 2014;34:611-615.