178587 Factors associated with diagnosed sexually transmitted diseases (STDs) during pregnancy among African American (AA) women

Monday, October 27, 2008: 11:20 AM

Susan M. Blake, PhD , School of Public Health and Health Services, George Washington University Medical Center, Washington, DC
M. Nabil El-Khorazaty, PhD , Statistics and Epidemiology Unit, RTI International, Rockville, MD
Marie Gantz, PhD , Statistics and Epidemiology Unit, RTI International, Rockville, MD
Pragatha Katta, MPH , School of Public Health and Health Services, George Washington University Medical Center, Washington, DC
Renee Milligan, PhD , School of Nursing, Johns Hopkins University, Baltimore, MD
Margaret Rodan, ScD , Department of Pediatrics, Georgetown University, Washington, DC
Michele Kiely, DrPH , Division of Epidemiology, Statistics & Prevention Research, National Institute of Child Health and Human Development/NIH, Rockville, MD
Purpose: To identify correlates of diagnosed STDs during pregnancy among adult African American (AA) women.

Methods: Chart abstractions from n=889 low income AA women enrolled in a randomized behavioral counseling trial to reduce psychosocial and behavioral risks during pregnancy were combined with prenatal and postpartum interview data. Bivariate comparisons using Chi-square tests or ANOVA, and multivariable logistic regression analyses identified factors associated with a two-level (STD vs. No-STD) and 4-level variable reflecting a prior history of STDs.

Results: 22% had one or more diagnosed STDs during pregnancy; Syphilis (1.01%), Gonorrhea (3.94%), Chlamydia (12.49%), HPV (7.09%), and Condyloma (1.24%). The distribution of current and previous STD (PSTD) was as follows: 13% STD/PSTD, 9% STD/No-PSTD, 24% No–STD/PSTD, 54% No-STD/No-PSTD. In preliminary models of the 2-level variable, the odds of STD during pregnancy were increased among women with a positive drug tox screen (OR=1.99; 95% CI=1.05-3.75), or >1 partner at baseline (OR=1.56; 95% CI=1.07-2.28) and decreased among married (OR=0.36; 95% CI=0.15-0.87) and separated/divorced women (OR=.18, 95% CI=0.04-0.83) vs. those living with a partner. Other demographic (age, income), psychosocial (support, depression, substance use), reproductive (parity, family planning use, pregnancy intention), or partner-related (support, IPV) factors significant in bivariates, were not retained in the final model. Women with repeat STDs differed significantly from those without PSTD and warrants further investigation.

Conclusions: Consistent with the literature, substance use and partner characteristics contribute to STDs during pregnancy. Initial findings suggest the need to further identify correlates for women with and without a history of STDs.

Learning Objectives:
1. Describe recommendations for STD screening procedures in prenatal care. 2. List two important factors associated with diagnosed STDs during pregnancy. 3.Identify ways to improve screening and identification of STD’s during pregnancy.

Keywords: Prenatal Care, STD Prevention

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: History of research in HIV, STD, and pregnancy prevention
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Women’s health across the lifecourse
See more of: Maternal and Child Health