Sexually transmitted infections in pregnancy: Prevalence, coinfections, and pregnancy complications.

INTRODUCTION

Sexually transmitted infections (STIs) during pregnancy can lead to relevant maternal-fetal complications. The role of other microorganisms such as Mycoplasma genitalium in gestational screening remains a matter of debate. In this context, we analyzed the prevalence of STIs and microorganisms considered saprophytes, as well as their association with pregnancy complications.

METHODS

We conducted a longitudinal study including 742 pregnant women during the first trimester (2021-2023). Vaginal samples were tested by PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Mycoplasma hominis, Ureaplasma parvum, Ureaplasma urealyticum, and Trichomonas vaginalis. Sociodemographic and clinical-reproductive variables were collected, and pregnancy complications were recorded.

RESULTS

A total of 56.3% of pregnant women harbored at least one of the microorganisms studied. The overall prevalence of STIs was 4.7%, significantly higher among women aged ≤25 years (15.6%). Overall and ≤25-year prevalence rates were Chlamydia trachomatis 2.0% and 7.8%; Mycoplasma genitalium 2.2% and 7.8%; Neisseria gonorrhoeae 0%; and Trichomonas vaginalis 0.5% and 0%. Coinfection was observed in 31.1% of cases, predominantly involving Ureaplasma parvum (>47%). Of all pregnancies studied, 92 (12.4%) presented complications, mainly miscarriages (50%). No STI was significantly associated with these complications.

CONCLUSION

A high prevalence of STIs was observed, particularly among younger pregnant women. Although the findings do not support expanding universal screening, the results endorse maintaining targeted strategies for women aged ≤25 years and highlight the need to further investigate the clinical impact of Mycoplasma genitalium on maternal-fetal health.