Trends and Characteristics of Sexually Transmitted Infections During Pregnancy: United States, 2016-2018

Questions for Elizabeth Gregory, Health Statistician and Lead Author of “Trends and Characteristics of Sexually Transmitted Infections During Pregnancy: United States, 2016-2018.”

Q: Why did you decide to a study on sexually transmitted infections (STI) during pregnancy?

EG: Maternal STIs during pregnancy are infrequently reported but important health issues given the potential for negative health outcomes for both women and infants. However, there have been limited studies on the prevalence and characteristics of women with STIs during pregnancy.  Data on chlamydia, gonorrhea, and syphilis were new to the 2003 revision of the birth certificate, and with all jurisdictions using the 2003 birth certificate revision starting in 2016, we decided to look at trends and rates of these STIs by selected characteristics.

Q: How did you obtain this data for this report?

EG: Birth certificate data for 2016–2018 were analyzed for trends, while a more detailed analysis was conducted using 2018 data.

Q: Can you summarize how the data varied by rates by selected characteristics?

EG: The rates for the three maternal STIs studied increased 2% (chlamydia), 16% (gonorrhea), and 34% (syphilis), from 2016 through 2018.  In 2018, rates of chlamydia and gonorrhea decreased with advancing maternal age whereas those for syphilis by maternal age decreased with age through 30-34 years and then increased for women aged 35 and older.  In 2018, rates of all three STIs were highest for non-Hispanic black women, women who smoked during pregnancy, women who received late or no prenatal care, and women for whom Medicaid was the principal source of payment for the delivery.  Among women aged 25 and over, rates of each of the STIs decreased with increasing maternal education.

Q: Do you have data that goes back further than 2016?

EG: Due to the staggered implementation of the 2003 revision of the birth certificate by the states, 2016 is the first data year for which we have national data on these items.  We do have data for earlier years, but they are subnational.

Q: What is the take home message for this report?

EG: The rates for chlamydia, gonorrhea, and syphilis increased from 2016 through 2018.  Rates for these STIs varied by selected characteristics, but were generally highest among younger women, non-Hispanic black women, women who smoked during pregnancy, women who received late or no prenatal care, and women for whom Medicaid was the principal source of payment for the delivery.