INFECTION OF GONORRHEA AND CHLAMYDIA DURING PREGNANCY, LOUISIANA 1997-2004

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INFECTION OF GONORRHEA AND CHLAMYDIA DURING
PREGNANCY, LOUISIANA 1997-2004

• Duc Ngo, MD, MPH
• Thao Nguyen, MD, MPH
• Tri Tran, MD, MPH
• Lisa Longfellow, MPH

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Background

• The prevalence of sexually transmitted diseases
  (STDs) including gonorrhea, chlamydia, and
  syphilis has, over the past 8 years, been
  consistently higher in Louisiana than in other
  states in the US.
• Overall STD prevalence among pregnant women
  increased among both blacks and whites in LA from
  1997 to 2004

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STD Rates (per 100,000 population) of Louisiana
compared to United States, 2004
National Rank of Louisiana Chlamydia Third
highest rate Gonorrhea Second Syphilis First
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Study question

• What were the trends of the prevalence of
  gonorrhea and chlamydia infection during
  pregnancy by race (all races, white, and black)
  in Louisiana from 1997 to 2004?

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Methods

• 1996-2004 STD data were linked with 1997-2004
  birth records data using backward, deterministic
  and probabilistic data linkage methods. STD data
  include chancroid, chlamydia, gonorrhea,
  syphilis, and lymphogranuloma venereum, which are
  STDs with reporting requirement (Louisiana Public
  Health Sanitary Code).
• SAS 9.1 and Linkpro 3.0 were used for the data
  linkage procedures and data analyses.

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Methods (cont.)

• A woman was defined to be infected by STDs during
  pregnancy if the time between the date of
  diagnosis with STDs and the date of delivery was
  less than or equal to gestational age of her
  newborn.
• One-sided linear regression was used to analyze
  the trends of prevalence of all STD, gonorrhea,
  and chlamydia infection during pregnancy from
  1997 to 2004. Alpha was set at .05 for
  statistical significance

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Results
Table 1 Percent of STDs during Pregnancy by
Maternal Characteristics, Louisiana 2000-2004
Maternal characteristics Maternal characteristics STDs (CI 95)
Race White 1.3 (1.2, 1.3)
Race Black 10.4 (10.2, 10.6)
Race Others 1.7 (1.5, 2.0)
Married No 10.0 (9.8, 10.1)
Married Yes 0.6 (0.6, 0.7)
Prenatal care entry First trimester 4.2 (4.2, 4.3)
Prenatal care entry After 1st or No PNC 9.1 (8.9, 9.4)
Geography Urban 3.9 (3.8, 4.0)
Geography Rural 5.9 (5.8, 6.0)
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Results (cont.)
Table 1 Percent of STDs during Pregnancy by
Maternal Characteristics, Louisiana 2000-2004
(cont.)
Mother Characteristics Mother Characteristics STDs (CI 95)
Age (years) lt15 14.9 (12.8, 16.9)
Age (years) 15-19 12.2 (11.9, 12.5)
Age (years) 20-24 6.9 (6.8, 7.1)
Age (years) 25-29 2.4 (2.3, 2.5)
Age (years) 30-34 1.0 (0.9, 1.1)
Age (years) gt 35 0.7 (0.6, 0.8)
Education (years) lt 10 9.1 (8.7, 9.4)
Education (years) 10-12 7.0 (6.8, 7.1)
Education (years) gt 12 1.8 (1.7, 1.8)
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Results (cont.)
Figure 1 Trends () of STDs during Pregnancy ,
Louisiana 1997 2004
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Results (cont.)
Annual increase in percentage of STDs during
pregnancy from 1997 to 2004 in Louisiana

• White 0.11 (CI 95 0.06, 0.17)
• Black 0.66 (CI 95 0.49, 0.84)
• All races 0.33 (CI 95 0.23, 0.43)

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Results (cont.) Figure 2 Trends () of
Chlamydia Infection during Pregnancy, Louisiana
1997 2004
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Results (cont.)
Annual increase in percentage of chlamydia
infection during pregnancy, from 1997 to 2004 in
Louisiana

• White 0.12 (95 CI 0.08, 0.15)
• Black 0.11 (95 CI 0.09, 0.12)
• All races 0.11 (95 CI 0.09, 0.12)

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Results (cont.)
Figure 3 Trends () of Gonorrhea Infection
during Pregnancy, Louisiana 1997 2004
P values for all trend tests gt .05
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Conclusion

• In Louisiana, the prevalence of overall STDs and
  chlamydia infection during pregnancy increased
  steadily, especially among blacks, from 1997 to
  2004.
• No statistically significant changes were
  observed for gonorrhea among pregnant women in
  the same time period.

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Pubic Health Implications

• An effective intervention program targeting
  reducing chlamydia infection among pregnant women
  will decrease overall STDs among pregnant women
  in Louisiana.