Prevalence of sexually transmitted infections in pregnant urban Aboriginal and Torres Strait Islander women in northern Australia.
OBJECTIVE
To assess the prevalence of sexually transmitted infections (STI) in a cohort of pregnant urban Indigenous women and association of STI with preterm birth, low birthweight birth and perinatal mortality.


METHODS
Prospective intervention program in a cohort of women attending Townsville Aboriginal and Islander Health Services (TAIHS) for shared antenatal care between 1 January 2000 and 31 December 2003 incorporating routine screening for chlamydia, gonorrhoea, trichomoniasis, hepatitis B and syphilis.


METHODS
Townsville is a provincial urban centre with a regional Indigenous population of over 16 000.


METHODS
Four hundred and fifty-six pregnant women who were screened for bacterial STI and other viral infections.


METHODS
Prevalence of STI, associated risk factors and perinatal outcomes.


RESULTS
Of the 456 women, 403 (88.4%) were screened for chlamydia, gonorrhoea and trichomonas and 432 (94.7%) were screened for syphilis. A total of 92 cases of STI (20.2%, 95% CI 16.5-23.9) were detected, with 21 concurrent infection(s). The overall prevalence of chlamydia was 14.4%, gonorrhoea 6.1%, trichomoniasis 7.2% and infectious syphilis 2.5%. Predictors for STI were young age, harmful/hazardous alcohol use and unwanted pregnancy. Low birthweight and perinatal death were significantly associated with the presence of STI and infectious syphilis during pregnancy.


CONCLUSIONS
The prevalence of STI among pregnant women in this urban Indigenous community is high, suggesting that screening for STI should be included in all antenatal care protocols for Indigenous women in Australia. Strategies to reach the whole Indigenous community of child-bearing age, especially those aged less than 25 years, are needed to improve perinatal outcome.
Panaretto
Kathryn S
KS
Townsville Aboriginal and Islanders Health Service, Townsville, Queensland, Australia. kpanaretto@taihs.net.au
Lee
Heather M
HM
Mitchell
Melvina R
MR
Larkins
Sarah L
SL
Manessis
Vivienne
V
Buettner
Petra G
PG
Watson
David
D
D000328:Adult; D005260:Female; D006303:Health Services, Indigenous / Q000706:statistics & numerical data; D006801:Humans; D007226:Infant Mortality; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D011256:Pregnancy Outcome; D011295:Prenatal Care; D015995:Prevalence; D011446:Prospective Studies; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples