Abstract

Background: Often asymptomatic in nature, sexually transmitted infections (STIs) are highly prevalent in women of reproductive ages, leading to adverse perinatal outcomes. This study investigated the association between STIs during pregnancy and the risk of adverse perinatal outcomes using comprehensive population-linked data from the Northern Territory (NT), Australia. Methods: This population-based retrospective cohort study examined births (live births and stillbirths) from the NT Perinatal Data Collection and the NT Notifiable Diseases register from 2005 to 2020. All singleton births (N = 59,465) were included, along with infectious disease notifications of four STIs that occurred during pregnancy: chlamydia, gonorrhoea, trichomoniasis, and syphilis. Relative risks (RR) for associations between STIs during pregnancy with adverse perinatal outcomes (pre-labour rupture of membranes, preterm birth, small-for-gestational age, stillbirth) were estimated using robust Poisson regression models. Findings: For babies born with congenital syphilis (n = 23), there was an association with preterm birth (RR 3.34, 95% confidence interval (CI) 1.80–6.17) and small-for-gestational age (RR 2.22, 95% CI 1.34–3.67). Small-for-gestational age was associated with maternal chlamydia (RR 1.86, 95% CI 1.54–2.24), maternal gonorrhoea (RR 1.76, 95% CI 1.46–2.12), and maternal trichomoniasis (RR 1.10, 95% CI 1.01–1.20). Associations were also observed between gonorrhoea and stillbirth (RR 1.97, 95% CI 1.19–3.27), and trichomoniasis with preterm birth (RR 1.23, 95% CI 1.09–1.39). Interpretation: STIs during pregnancy showed notable associations with adverse birth outcomes. Congenital syphilis most severely affected outcomes, tripling preterm birth risk and doubling small-for-gestational age risk. These findings underscore the importance of addressing barriers to STI screening and treatment prior to and during pregnancy. Funding: National Health and Medical Research Council and the Western Australian Future Health Research and Innovation Fund.

RAS ID

82344

Document Type

Journal Article

Date of Publication

7-1-2025

Volume

60

Funding Information

Curtin School of Population Health / National Health and Medical Research Council / Western Australian Future Health Research and Innovation Fund / Edith Cowan University

School

School of Nursing and Midwifery

Grant Number

NHMRC Numbers : 1099655, 1173991, 1195716

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Publisher

Elsevier

Identifier

Amanuel T. Gebremedhin: https://orcid.org/0000-0003-2459-1805

Comments

Dunne, J., Tessema, G. A., Legge, M., Nyadanu, S. D., Roy, A., Gebremedhin, A. T., Hendriks, J., Reid-Moore, T., & Pereira, G. (2025). The association between sexually transmitted infections and pregnancy outcomes in the Northern Territory, Australia: a population-based cohort study. The Lancet Regional Health Western Pacific, 60, 101610. https://doi.org/10.1016/j.lanwpc.2025.101610

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