A threat to healthy births in Australia

A study of 15 years of nearly 60,000 births shows that congenital syphilis and other STIs continue to endanger babies, as obstacles to health care in Australia, undergo otherwise effective screening programs.

Study: The association between sexually transmitted infections and the results of pregnancy in the northern territory, Australia: a cohort study based on the population. Similarly, Image credit: Saiful52 / Shutterstock.com

Sexually transmitted infections (IST) are very widespread in women of reproductive age. However, Although often asymptomatic, they can cause serious complications of pregnancy. Furthermore, A recent article in Lancet examined the results at the birth of a cohort based on threat healthy births australia the population in the northern territory. Therefore, in Australia, to assess the relative risk of pregnancy complications with IST.

Introduction – Threat healthy births australia

According to the World Health Organization. Therefore, there were 374 million new IST cases in 2020, among people between 15 and 49 years old, caused by only four notifiable conditions: Chlamydia, Gonorrhée, Trichomonase and Syphilis. For example, Most cases are under 35 years old.

IST rates are increasing in Australia, but most are not diagnosed and not treated. For example. Nevertheless, two out of three chlamydial infections among Australians aged 15 to 29 are missed, which makes it difficult to prevention and control the propagation of these infections. Furthermore, The Northern territory is a particular challenge because the average notification rates of AST are much higher than the national average. In addition, up to ten times higher in the case of Gonorrhea, and four times with Chlamydia.

threat healthy births australia

Several factors contribute to this situation. Therefore, The territory is geographically distant, culturally disparate and has bad health establishments. For example, only three public hospitals and a private hospital serve an area of 1.4 million square kilometers.

Although these high numbers reflect active surveillance. Moreover, screening rates, they also suggest poor disease control, in particular affecting the aboriginal and island peoples of the Strait of Torres, which constitute a third of people living here. For example, These groups of people have to quintuple the rates of syphilis and gonorrhea that non -Aboriginal people do. The most isolated parts of the northern territory have an endemic trichomonase. which is only notifiable in this part of Australia.

Previous research indicates that STIs during pregnancy reduce the chances of favorable results. The putative. established mechanisms include an ascending infection or a production of inflammatory cytokines, causing deciding inflammation, leading in certain cases to threat healthy births australia the premature rupture of fetal membranes or maturation and cervical expansion. The two mechanisms can trigger a premature birth.

The worst impact comes from syphilis. since the Treponema pale The pathogen crosses the placenta to infect the fetus from 9 to 10 weeks. It causes large -scale inflammation and hurts the placental vascular system. The results include placental insufficiency, poor fetal growth and mortinity.

The undesirable effects of STIs on pregnancy are largely preventable by appropriately detection, diagnosis and antibiotic treatment. Most previous studies have been small or based on the detection of a single STI. Aboriginal populations have been widely excluded from these studies. This study examined associations between several STIs. poor pregnancy results in a sample with a high percentage of Aboriginal people and with a prevalence of substantial STI.

Threat healthy births australia

About the study

The cohort included 59. 465 Singleton pregnancies, which were threat healthy births australia stratified by the presence of one of these four notifiable STIs. A type of statistical analysis called fish regression has been carried out to assess robust associations between these diseases. the unfavorable results of pregnancy in this cohort. The results of interest were the prior break in the membranes, the premature birth, the small age and the mortincy.

Study results

Alcohol. smoking were rare in this cohort, more than a third being indigenous or islanders of the Torres Strait. Trichomonas infection affected 4%, followed by chlamydia (2.6%) and gonorrhea (1.4%), but only 0.2%had a syphilis. Among the babies born of this cohort, 51 and 23 had a congenital chlamydia and a congenital syphilis, respectively, less than 0.1% each. Although this reflects a generally effective screening. the study pointed out that the 23 cases of congenital syphilis report in progress gaps in monitoring and access to care. Congenital threat healthy births australia gonorrhea levels were low (<20 cases) and were not analyzed in detail.

The study revealed that the most serious results were linked to congenital syphilis, not to a maternal infection alone. Congenital syphilis has more than tripled the risk of premature delivery (RR 3.34) and has doubled the risk of being born small for gestational age (SGA) (RR 2,22). Maternal STIs such as chlamydia, gonorrhea and trichomonase were mainly associated with a higher risk of SGA (RRS 1.86, 1.76 and 1.10, respectively). Among these. Gonorrhea was the only maternal infection associated with mortiniance (RR 1,97), and trichomonase included a modestly increased risk of premature birth (RR 1,23), the SGA remaining the most coherent unwanted result in all pathogenic agents.

There was no evidence that a maternal STI was linked to a premature rupture of the membranes. the specifically spontaneous premature birth. The combination of gonorrhea. trichomonase during the double pregnancy threat healthy births australia almost the risk of SGA (RR 1,81), but no multiplicative effect was observed for other co-infections.

The researchers found that congenital syphilis was the most serious STI in terms of unfavorable birth results. While prenatal screening programs in the northern territory seem effective overall. in particular for the prevention of syphilis, gaps remain due to logistics, geographic and cultural barriers, which are likely to explain why 23 cases of congenital syphilis have always occurred.

The high rate of unwanted results in pregnancies complicated by the STIs indicates that the challenges of implementation. rather than the design of the screening protocol alone, are the main obstacles. The results corroborate the high risks associated with untreated maternal syphilis reported in previous meta-analyzes, but not urban studies. This disparity emphasizes the logistical challenges specific to this framework.

Conclusions

« These results underline the importance of dealing with obstacles to screening threat healthy births australia and treatment of STIs before and during pregnancy. «

Congenital syphilis continues to cause a significant burden on the complications of pregnancy. emphasizing the need for preventive measures and control against this infection. This need is particularly important in regions where the burden of STIs is high.

The study highlights the need for rapid. repeated screening beyond the first quarter, culturally safe care, reinforced monitoring and the improvement of health infrastructure to reduce these risks, rather than relying only on behavioral strategies such as abstinence or monogamy advice, which have not been recommended by this study.

Download your PDF copy now!