Sexually transmitted diseases and risk behaviors among pregnant women attending inner city public sexually transmitted diseases clinics in Baltimore, MD, 1996-2002

OBJECTIVE: To determine the prevalence of sexually transmitted diseases (STDs) and characterize behavioral correlates among pregnant women attending inner city public STD clinics. STUDY DESIGN: A retrospective study of 2303 pregnant women frequency matched by clinic and year of visit to 2303 nonpregnant women seeking services during years 1996 to 2002 at public STD clinics in Baltimore, MD. RESULTS: On average, 329 pregnant women attended Baltimore City STD clinics each year during 1996 to 2002. Forty-six and a half percent of pregnant women knew they were pregnant when they presented to the STD clinic. Although pregnant women were younger (23.3 vs. 28.3 years of age, P <0.01) and more likely to have sought STD clinical services in the past (55.4% vs. 51.5%, P <0.01), they were less likely to report high-risk sexual behaviors such as new (4.6% vs. 7.0%, P <0.01) or multiple sex partners (11.6% vs. 13.9%, P <0.01) than nonpregnant women. However, prevalence of gonorrhea (4.8% pregnant vs. 4.2%), chlamydia (9.9% vs. 7.7%), trichomoniasis (12.4% vs. 12.0%), and early syphilis (1.5% vs. 1.2%) was high, and both groups were equally as likely to have any STD. CONCLUSION: The prevalence of STDs was similar for pregnant and nonpregnant women attending the inner city public STD clinics, despite differences in risk factors for STDs. Understanding the impact of STDs on perinatal outcomes among this population and developing targeted interventions to reduce STD-related maternal and infant morbidity are critical public health issues.