Association between maternal sexually transmitted diseases and birth defects in the United States: A nationwide population-based study

Purpose: We estimated the association between maternal sexually transmitted diseases (STDs) and the risk of specific birth defects among live singleton births in the United States (US). Methods: We conducted a population-based study using data from birth certificates for 14,602,822 live singleton births occurring from 2016 to 2019 in the US. We used logistic regression to estimate the associations between three maternal STDs (chlamydia, gonorrhea, and syphilis) and the risk of four specific birth defects (gastroschisis, cleft lip with or without cleft palate, spina bifida, and hypospadias), adjusting for socio-demographic and pregnancy-related factors. Results: Maternal chlamydia infection was associated with a higher risk of gastroschisis (adjusted odds ratio [aOR], 1.23; (95 % CI: 1.03, 1.46), cleft lip with or without cleft palate (aOR, 1.26; 95 % CI: 1.08, 1.47), and hypospadias (aOR, 1.26; 95 % CI: 1.08, 1.47). It was not associated with an increased risk of spina bifida. These associations were consistent across subgroups defined by maternal age, race and ethnicity, education, body mass index, and infant sex. We found no evidence of an association between gonorrhea or syphilis infections and the studied birth defects. Conclusions: Among live singleton births in the US, maternal chlamydia infection may be associated with increased risks of gastroschisis, cleft lip with or without cleft palate, and hypospadias.