These STDs have significant consequences for mother and child (see also Chapters 33 and 34). Untreated syphilis in pregnancy can cause late abortion, stillbirth, transplacental infection, and congenital syphilis. Gonorrhea can produce large-joint arthritis by hematogenous spread as well as ophthalmia neonatorum. Maternal chlamydial infections are largely asymptomatic but are manifested in the newborn by inclusion conjunctivitis and, at age 2–4 months, by pneumonia. The diagnosis of each can be reliably made by appropriate laboratory tests. All women should be tested for syphilis as part of their routine prenatal care. Pregnant women younger than 25 years and those at increased risk for C trachomatis should be screened for chlamydia at their first prenatal visit. Repeat testing depends on risk factors, prevalence, and state laws. A pregnant woman treated for C trachomatis should be tested for cure 4 weeks later and then retested 3 months later because of high reinfection rates. Women who remain at high risk should be tested in the third trimester. Women younger than 25 years and those at increased risk should be tested for gonorrhea at their first prenatal appointment. Women with positive tests for gonorrhea should be treated and then retested 3 months later. Women who remain at high risk should be tested in the third trimester. The sexual partners of women with STDs should be identified and treated if possible; the local health department can assist with this process.
et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021:70:1.