Sexually Transmitted Infections and Pregnancy Outcomes in Women without Antenatal Care at Siriraj Hospital

Abstract

Objective: To demonstrate prevalence of sexually transmitted infections (STIs) and pregnancy outcomes in Thai pregnant women without antenatal care (ANC) who delivered at Siriraj Hospital.
Methods: Medical charts of pregnant women without ANC who delivered at Siriraj Hospital during 2010-2014 were reviewed. Data of all deliveries during the same time period were used for the comparison.
Results: During 2010-2014, out of 46,486 deliveries, 1,057 had no ANC, ranging from 197 to 229 / year. The average age was 25.5 ± 6.5 years and 85% were married. Prevalence of HIV infection, hepatitis B and other STIs in patients without ANC were 5.9% (62/1,057), 3.3% (35/1,057) and 1.4% (15/1,057), respectively. One third had consumed
recreational drugs and urine amphetamine was positive in 20.8% of patients. The frequency of current smokers and current alcohol consumers were 14.6% (154/1,057) and 3.8% (40/1,057). Compared with all deliveries, those without ANC had significantly higher adverse pregnancy outcomes, including preterm birth (39.1% vs 14.0%,
RR 2.29, 95%CI 2.10-2.49), birthweight < 2,500 gms (25.9% vs 12.6%, RR 1.84, 95%CI 1.65-2.05) and birthweight < 1,500 gms (4.1% vs 1.3%, RR 3.08, 95%CI 2.28-4.18). Teenage pregnancy significantly increased risk of preterm birth (aOR 1.86, 95%CI 1.36-2.55) and being separate doubled the risk of birthweight < 1,500 gms (aOR 2.13,
95%CI 1.02-4.46) after adjusting for history of recreational drug use, urine amphetamine, smoking, marital status, maternal age and concurrent STIs.
Conclusion: STIs and adverse pregnancy outcomes were highly prevalent among deliveries without ANC. Teenage
pregnancy and lack of family support appears to increase the risk of poor pregnancy outcomes.