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Chapter 1 : Pregnancy Outcomes Related to Sexually Transmitted Diseases
The relationship between pregnancy outcome and maternal colonization with sexually transmitted bacterial and viral organisms has been studied for many years. The more classic sexually transmitted diseases, syphilis, gonorrhea, herpes, trichomonas, and Chlamydia infection, are almost always transmitted between adults by sexual contact. The majority of human immunodeficiency virus (HIV) infections in reproductive-age women are transmitted sexually. The etiology of these miscarriages is generally secondary to maldevelopment of the ovum and associated chromosomal abnormalities. Mental retardation is another outcome measure of great importance but one whose prevalence in the population is difficult to determine with certainty. While perinatal infections such as group B Streptococcus, herpes simplex virus, and cytomegalovirus infections, syphilis, and toxoplasmosis all are demonstrated causes of mental retardation, infection-initiated preterm birth appears to be a more important cause of mental retardation from the overall public health perspective. It is emphasized that because many of these outcomes occur only rarely and first become apparent later in life, perinatal researchers often use surrogate measures of adverse outcome, such as preterm birth, growth retardation, and low birth weight, or the continuous measures of mean birth weight and mean gestational age to define adverse pregnancy outcome. An appreciation of the effect of bacterial vaginosis on outcomes of pregnancy associated with preterm birth gives bacterial vaginosis a greater public health importance than has been attributed to it in the past.
Adverse outcomes associated with direct fetal or neonatal infections
Estimated effect of direct fetal and neonatal infection with various STDs on adverse outcomes of pregnancy each year in the United States a
Estimated effect of various sexually transmitted diseases on adverse outcomes of pregnancy through their effect on preterm birtah a