Untreated gonorrhoea during pregnancy may cause life-threatening complications in newborns

A Senior Lecturer at the Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Dr. Ochuwa Babah, has highlighted the dangers associated with untreated gonorrhoea, especially in pregnancy, warning that it can lead to life-threatening complications in babies.

Citing a study published in the Journal of American Sexually Transmitted Diseases Association, the consultant obstetrician and gynaecologist said 50 per cent of untreated maternal gonorrhoea infections are transmitted to the neonate during birth.

Dr. Babah noted that gonorrhoea has a devastating impact on babies, especially for those that survive it, warning that it could cause eye and lower respiratory tract infections.

Speaking in an interview with PUNCH Healthwise, the maternal health expert said gonorrhoea in pregnancy requires proper treatment to achieve full cure, adding that vaginal discharge is the most common symptom in women with the infection.

She said, “Gonorrhea infection is among the many sexually transmitted diseases. In the past, there used to be this general belief that sexually transmitted diseases cannot occur during pregnancy.

“But we now have evidence to show that they do occur in pregnancy. Gonorrhea in particular is an infection that can occur in about zero to 14.2 per cent of pregnancies. The prevalence varies from place to place, depending on the behavioural attitude of the people.

“Gonorrhea is not as common as Chlamydia trachomatis, which is another sexually transmitted disease. But it has been found to impact adversely on pregnancy, both in women that have HIV and even in women that do not have HIV.

“The most common of these complications is the occurrence of continuous miscarriage. It starts with vaginal bleeding and some abdominal cramp and before you know it, the bleeding becomes heavy and by the time the woman gets to the hospital, she would be told she has lost the pregnancy. This usually happens at the early stage of the pregnancy.”

According to her, untreated STIs in pregnancy are associated with adverse outcomes in the neonate, such as conjunctivitis, pneumonia, sepsis and infant death.

“Researchers in a study published in the Journal of American Sexually Transmitted Diseases Association, found that about 50 per cent of untreated maternal gonorrhea infections are transmitted to the neonate during birth.

“This infection spreads upward from the vagina towards the cervix and then towards the uterus. It weakens the membrane surrounding the baby. When the weak membrane gets torn, the water drains out. So, the woman can present with what we call premature rupture of the membrane.

“Also, the infection might spread to the uterine lining and cause irritation that will trigger a contraction and the woman will go into early labour. If the infection becomes overwhelming, it can affect the baby to the extent of killing the baby. At the end of the day, the baby dies in the womb,” Dr. Babah said.

The gynaecologist noted that babies that are born alive might develop certain health problems.

“They are likely to develop infection and this infection, if it spreads to the brain, can cause neonatal meningitis. The baby may have inflammation of the eye,” he added.

Dr. Babah pointed out that Chlamydia trachomatis and gonorrhoea have been found to be independently factored for certain complications that can occur in pregnancy.

The maternal health expert affirmed that if diagnosed, gonorrhoea can be effectively treated, urging women who have been treated to ensure that their husbands are also treated to avoid re-infection.

She, however, said that while pregnant women are screened for sexually transmitted diseases such as syphilis, HIV and Hepatitis B during antenatal clinics, gonorrhoea is not part of routine screening in antenatal clinics yet.

She advised pregnant women with the infection to avoid self-medication, urging them to seek proper medical care from qualified medical personnel to avoid the drugs having further negative impacts on their babies.

A study published in the European Journal of Obstetrics & Gynecology and Reproductive Biology, says STIs, particularly during pregnancy, are neglected health issues despite the negative impact on feto-maternal and infant outcomes.

According to the study authors, Chlamydia trachomatis and gonorrhoea are the most common sexually transmitted infections in pregnancy and usually cause significant morbidity if left untreated.

“Screening for sexually transmitted infections in pregnancy is necessary, as chlamydial and gonococcal genital infections in women are largely asymptomatic and up to 50 per cent of infected pregnant women could be asymptomatic.

“Women with asymptomatic, untreated sexually transmitted infections in pregnancy have 3.3 times higher risk of a preterm delivery, compared to those that received treatment,” the researchers said.

The World Health Organisation says with over one million sexually transmitted infections occurring daily globally, it is vital for countries to tackle this challenge in order to achieve Sustainable Development Goal 3 on universal access to sexual and reproductive healthcare services.