Sexually transmitted and blood-borne infections (STBBIs) and pregnancy

If you are pregnant, pregnancy care is essential to ensuring that you and your child are healthy. During your pregnancy care appointments, health-care professionals will assess your sexual health. You’ll be asked for instance, whether you have or have had sexually transmitted and blood-borne infections (STBBIs), such as genital herpes, etc. Among other things, you will be recommended screening tests for certain STBBIs. Many people with an STBBI do not show symptoms. You or your partner could be infected without knowing it.

STBBIs can affect the course of your pregnancy, your health and that of your child.

If you have an STBBI, treatments can limit or eliminate risks for you and your child.

STBBIs are spread in various ways:

• Through sex
  • Oral sex (contact of the mouth with the penis, vulva, vagina or anus)
  • Vaginal sex (penetration of the vagina with the penis)
  • Anal sex (penetration of the anus with the penis)
  • Genital contact between partners
  • Sharing of sex toys
• Through blood
  • Sharing of paraphernalia used to prepare, inject or inhale drugs
  • Tattooing or piercing with non-sterile equipment
  • Contact between a liquid contaminated by blood with 
    • Damaged skin surface
    • Mucous membranes 
  • Blood transfusions where safety measures are not applied (they are applied in Canada)
• From mother to child
  • During pregnancy
  • At childbirth
  • During breastfeeding

A pregnant woman with an untreated STBBI can:

• Have a miscarriage
• Deliver prematurely
• Have an intrauterine infection (inside the uterus)
• Have a stillborn baby

She can also transmit the infection to her child. In newborns, STBBIs can be serious, sometimes even fatal. The child may develop a chronic infection (e.g., HIV or hepatitis B), a more or less severe form of the disease (e.g., congenital herpes or syphilis) or develop complications that can have permanent effects on the the child’s health and development, such as:

• Newborns getting an HIV infection or hepatitis B
• Serious eye infection that can lead to blindness in newborns with gonorrhea
• Anemia or liver, spleen and bone abnormalities in newborns with syphilis
• Delayed development in newborns with herpes or syphilis

These complications can be avoided or their effects limited by following recommendations for the assessment of pregnant women’s sexual health and STBBI screening during pregnancy.

Early in your pregnancy, your doctor, nurse or midwife will prescribe blood and urine tests and vaginal swabs.

These analysis include screening tests for the following STBBIs:

• Chlamydia
• Gonorrhea
• Hepatitis B
• Syphilis
• HIV

Chlamydia and gonorrhea are screened by analyzing a sample taken from inside the vagina. In some cases, these infections can also be screened through urine analysis. Hepatitis B, syphilis and HIV are screened through blood analysis.

In some cases, health-care professionals may recommend screening tests for other STBBIs, such as genital herpes or hepatitis C.

Certain behaviours increase the risk of STBBIs, such as having unprotected sex or sharing drug paraphernalia. If you or your partner engage in such behaviour, inform the health-care professionals monitoring your pregnancy. They can assess whether you should be screened for STBBIs again if you have already done so in the past.

You can decline an STBBI screening test. Simply let your health-care professionals know. If you have questions or concerns, you can discuss these with them during your pregnancy care.

When a pregnant woman has an STBBI, several treatments can prevent complications associated with the transmission of infections to newborns.

• In pregnant women:
  • Treatment of the infection
  • In some cases, a caesarean delivery may be recommended
• In newborns:
  • Evaluation and monitoring of health condition
  • Treatment of the infection