Sexually transmitted infections among pregnant women attending an antenatal clinic in Fuzhou, China.
OBJECTIVE
To determine the prevalence of sexually transmitted infections (STIs) among women attending an antenatal clinic in urban China and to show whether reported symptoms and findings on clinical examination predicted STIs in this population.


METHODS
Cross-sectional descriptive study was conducted among 504 pregnant women attending an antenatal clinic in Fuzhou, China. Structured questionnaires were used to collect demographic and behavioral information, and clinical and gynecologic examinations were performed to detect clinical signs of STIs. Blood samples, vaginal swabs, and cervical swabs were collected, respectively, to test for antibodies to syphilis, culture Trichomonas vaginalis (T. vaginalis), and perform PCR to detect Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonorrhoeae).


RESULTS
C trachomatis was detected in 51 (10.1%), N gonorrhoeae in 4 (0.8%), T vaginalis in 16 (3.2%), and syphilis in 1 (0.2%) of the 504 pregnant women. Fifty-two (73%) of 71 women with any STI were asymptomatic. Multiple logistic regression analysis indicated that age <or=25 years (OR=2.72) and monthly income >RMB 2000 yuan (OR=3.57) were significant independent risk factors for chlamydial infection (P<0.05). The reported symptom of vaginal discharge or the clinical sign of either vaginal or cervical discharge poorly predicted infection with C trachomatis, N gonorrhoeae, or T vaginalis, with a positive predictive value <25% for each STI.


CONCLUSIONS
A substantial prevalence of STIs, including a large proportion of asymptomatic infections, was found among pregnant women in the study area. These results support a strategy of screening pregnant women for bacterial STIs (followed by treatment of infections), which could be integrated into routine pregnancy care in China.
National Center for STD Control, Chinese Academy of Medical Sciences (CAMS) and Peking Union Medical College (PUMC) Institute of Dermatology, Nanjing, China. chenxs@vip.163.com
Xiang-Sheng
XS
Chen
Yue-Ping
YP
Yin
Lei-Ping
LP
Chen
Nguyen T T
NT
Thuy
Gui-Ying
GY
Zhang
Mei-Qin
MQ
Shi
Li-Hong
LH
Hu
Yan-Hua
YH
Yu
D000328:Adult; D000554:Ambulatory Care Facilities; D002681:China / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008403:Mass Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013587:Syphilis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014247:Trichomonas Vaginitis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control