Maternal STIs linked to birth complications

A study of almost 60,000 Australian births across 15 years has revealed common sexually transmitted infections (STIs) during pregnancy are linked to a higher risk of significant birth complications.
 
With adverse outcomes including preterm birth, stillbirth and babies born smaller than expected, the link has led researchers to call for an urgent bolstering of healthcare offerings, especially for those living in rural and remote areas.
 
The study, which focused on Northern Territory patients, found congenital syphilis triples the risk of preterm birth and more than doubles the risk of growth restriction among babies.
 
It also shows that gonorrhoea almost doubles the risk of stillbirth, and links maternal chlamydia, gonorrhoea, and trichomoniasis to babies being small for their gestational age.
 
‘These results underscore the importance of maintaining robust STI screening and treatment programs during pregnancy, especially in high-burden settings,’ the study concludes.
 
‘These findings provide actionable insights to enhance maternal and neonatal outcomes across Australia through the development of targeted screening protocols and evidence-based health promotion strategies, particularly in communities with high STI prevalence.’
 
Lead author Dr Jennifer Dunne said the findings reinforce the need for changes in STI testing during pregnancy amid the ‘potentially devastating outcomes’ for parents.
 
‘Current STI screenings happen early in pregnancy, but we need additional checks later in pregnancy, especially in high-risk areas,’ she said.
 
‘Many of these infections are common, preventable and treatable – we just need to be able to catch them in time to treat them as early as possible.’
 
The new research comes as STIs remain a global concern, especially with a high prevalence of diagnoses among those of reproductive age.
 
In Australia, STIs are on the rise, but most cases remain undiagnosed and untreated.
 
Last year, 8928 cases of syphilis were reported across Australia, compared to 3881 a decade ago, and 1962 cases in 2004.
 
Cases of gonorrhoea have jumped by two-thirds in the last 10 years, up to 44,552 in 2024, while more than 100,000 cases of chlamydia were reported last year across Australia.
 
Despite the prevalence of these infections, and screening programs already in place during pregnancy, the study says additional challenges to care include geographical isolation, cultural barriers, and late presentation to antenatal care.
 
‘Despite established screening protocols, these barriers may contribute to delayed diagnosis and treatment, potentially explaining the continued association between STIs and adverse pregnancy outcomes,’ it said.
 
The study’s co-author Dr Jacqui Hendriks said the research highlights the additional public health challenges faced by individuals living in remote and regional areas.
 
‘Barriers to timely testing and treatment still exist in isolated communities. The Northern Territory has some of the highest STI rates in Australia, yet healthcare access in remote areas is often limited,’ she said.
 
‘Our research suggests a need to strengthen culturally appropriate, accessible services to improve outcomes for parents and babies.
 
‘This includes follow-up care in remote settings, plus targeted education to raise awareness of STIs in pregnancy and the importance of early antenatal care.’
 
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antenatal care pregnancy sexually transmitted disease STI