Prematurity and STI – the value of screening and treatment Preterm birth is a significant cause of perinatal morbidity and mortality worldwide and strategies to prevent preterm birth have often focussed on infectious etiologies. In addition, prenatal care is a time when women access health care, even in resource limited settings, and poses a very important opportunity to optimize a woman’s health and ensure screening for communicable diseases, particularly STI’s is conducted. Screening and treating STI’s in any reproductive aged woman are important but treating in pregnancy requires appropriate selection of antimicrobials that will be the safest in pregnancy depending on the gestational age. Many STI’s have been associated with preterm birth but treating in all cases has not been consistently associated with prevention of prematurity. This talk will present data on the most common STI’s and sexually associated genital tract infections, and the individual value of screening and treating in pregnancy including; HIV, Hepatitis B, Hepatitis C, Syphilis, Herpes simplex, Trichomonas vaginalis, bacterial vaginosis, Chlamydia trachomatis, Neisseria gonorrheae, Mycoplasma genitalium, Mycoplasma hominus, Ureaplasma urealyticum. Screening and treatment of bacterial vaginosis has been studied extensively over time with variability in results. Many studies have shown an association of bacterial vaginosis with higher rates of preterm birth, but in low risk women treatment has not proven of benefit. In some studies, treatment of high-risk women has been beneficial. However, the lack of precision around the diagnosis of bacterial vaginosis has likely contributed to confusing results in the literature, and new methods of genomic analysis of the vaginal microbiome is leading to opportunities for much greater precision in the diagnosis of dysbiosis and targeted treatment trials that would be more promising than standard treatment has proven to be in the past.
Disclosure No significant relationships.
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