The Impact of Sexually Transmitted Infections on the Birth Outcomes for Women in Kalamazoo, Michigan Between 2008-2014
Introduction: Sexually transmitted infections (STI) pose a huge burden on the health of our society with more than 110 million infections currently in the United States. STIs are much more detrimental for women due to the risk of infertility and potential pregnancy complications. STIs can have many damaging impacts during pregnancy including stillbirth, premature rupture of membranes, preterm delivery and direct infections of the infant, or subsequent infant mortality. In Kalamazoo County the rates of STI infections are nearly double that of the state and nation. In addition, the rates of infant mortality in Kalamazoo County are also higher than state and national averages. To combat this public health epidemic, we conducted a case controlled retrospective study to examine the impact of STIs on the birth outcomes of women in Kalamazoo County. Materials and Methods: The birth and death records from women who gave birth in Kalamazoo were examined using bivariate tests for associations, and multiple logistic regression to assess the impact of health and demographic variables on the birth outcomes of infants born between 2008-2014. Poor birth outcomes were defined as prematurity less than 37 weeks, low birth weight less than 2500g, and infant mortality. Results: Uninfected mothers had greater odds of having a good birth outcome than women with STIs, specifically Chlamydia infection (OR 1.82, 95% CI 1.55, 2.11), Gonorrhea infection (OR 2.14, 95% CI 1.62, 2.82) or Herpes infection (OR 1.3, 95% CI 1.13, 1.49). There is an increased rate of Chlamydia infections per 1000 women who were; between the ages of 13 and 24 (93 versus 27), of color (105 versus 31), not college educated (69 versus 7), not married (99 versus 12), or on Medicaid (89 versus 12). These patterns were also consistent for Gonorrhea infections, but not Herpes. Conclusions: Data from this study indicates that STI infections in our community are increasing the risk of having a poor birth outcome. The factors that correlate with each STI to predict poor birth outcomes vary however. This research was undertaken in collaboration with community agencies, including Kalamazoo Community and Health Services, and our findings will help inform educational strategies to combat these problems within our community.