Objective: The purpose of this study was to determine the
epidemiology of sexually transmitted diseases (STDs) among pregnant adolescents.
Methods: Charts of all patients (n = 735) who attended the Maternal and
Infant Care Clinic at University Hospital, Newark, NJ, between July 1, 1991, and June 30,
1992, were reviewed for STDs which included gonorrhea, chlamydia, syphilis, and human
immunodeficiency virus (HIV). At the first prenatal visit, each registrant had endocervical
specimens obtained to detect gonorrhea and chlamydia. A serum sample was obtained
for syphilis screening. HIV testing was made available to all patients and testing was
done on a voluntary basis. The same STD screening that was done at the initial visit was
repeated at 28 and 36 weeks.
Results: Twenty-five percent of patients tested positive for one or
more STDs. The mean patient age was 17.3 years. The mean gestational age at first visit
was 19.5 weeks. The mean number of visits was 7.3. The following STDs were identified:
4.8% of patients tested positive for gonorrhea, 20.9% tested positive for chlamydia,
and 1.7% tested positive for syphilis. Twenty-one percent of patients had a positive
STD diagnosed at the initial visit. Another 4.8% of patients had an STD diagnosed at some
time after the initial visit when the initial screen was negative for STDs. An additional
1% of patients who initially tested positive for an STD had subsequent screening which
revealed another STD (different organism). Seven patients tested HIV positive.
Sixty-one percent of patients with STDs agreed to HIV testing. One patient had
HIV coexistent with another STD.
Conclusions: Pregnant adolescents are at risk for multiple
STDs. HIV testing should be offered. STD screening should be repeated in the third
trimester in adolescent patients.