Pregnancy and sexually transmitted infection

Verified and up to date on 21 March 2025
STIs during pregnancy

Pregnancy is a time of joy and anticipation – but also a phase in which the health of the expectant mother and the unborn child must be especially protected. Sexually transmitted infections (STIs) play a central role in this: they can go unnoticed and have serious consequences for both mother and child. In this article, you will learn which STIs can occur during pregnancy, what risks they pose, and how you can effectively protect yourself.

The WHO estimates that in 2022, approximately 1.1 million pregnant women worldwide were infected with the sexually transmitted infection syphilis, leading to more than 390,000 stillbirths (WHO, 2024).


Table of Contents


Can STIs be transmitted to the baby during pregnancy?

Yes, certain STIs can be transmitted to the baby during pregnancy, childbirth, or breastfeeding and can lead to severe complications such as developmental disorders, malformations, or even stillbirths. Below is a table of some STIs and their transmission routes:

STI Transmission route
HIV Pregnancy, childbirth, breastfeeding
Syphilis Pregnancy, childbirth (through direct contact with lesions)
Herpes Childbirth (through direct contact with lesions)
Chlamydia, Gonorrhea Childbirth
Hepatitis B Childbirth, rarely breastfeeding
HPV Childbirth (very rarely, through contact with infected tissue)

Source: Irshad, U. et al., 2023; NIH, 2019; CDC, 2024; CDC, 2020; LaCour, D. E., & Trimble, C., 2012.

Which STIs can occur during pregnancy?

The sexually transmitted infections (STIs) that can occur during pregnancy do not differ from those affecting non-pregnant women. These include chlamydia, gonorrhea, syphilis, HIV, genital herpes, trichomoniasis, hepatitis B, hepatitis C, and human papillomavirus (HPV). What makes them particularly concerning is that these infections can have especially serious consequences for the health of the mother and the unborn child during pregnancy (CDC, 2024).

How can STIs affect pregnancy and the unborn child?

Infections with STIs during pregnancy can have significant effects on the health of both mother and child. Depending on the timing and type of infection, they can lead to a range of complications for the unborn child:

  • Low birth weight (less than 5 pounds)
  • Eye infection
  • Pneumonia
  • Infection in the baby’s blood
  • Brain damage
  • Poor coordination of body movements
  • Blindness
  • Deafness
  • Acute hepatitis
  • Meningitis
  • Chronic liver disease, which can lead to liver scarring (cirrhosis)
  • Stillbirth

Source: NIH, 2019

What are the symptoms of an STI during pregnancy?

During pregnancy, STIs can cause symptoms similar to those in non-pregnant women, such as:

  • Unusual-smelling vaginal discharge
  • Burning during urination
  • Lower abdominal pain
  • Itching or redness
  • Irregular bleeding

However, many infections remain asymptomatic, making regular screenings essential to protect the health of both mother and child (Mayo Clinic, 2023).

Which STIs are tested for during pregnancy?

It is recommended that pregnant women are routinely screened for certain STIs to reduce risks for both mother and child. The list of recommended tests includes:

  • Chlamydia and gonorrhea: Routine testing, especially for young women and those at higher risk; repeat testing in the third trimester if necessary.

  • HIV: Testing at the beginning of pregnancy, and repeat testing in the third trimester if needed.

  • Syphilis: Testing at the beginning of pregnancy and repeat testing if indicated.

  • Hepatitis B: Testing at the beginning of pregnancy.

  • HPV: Pregnant women should be screened at the same intervals as non-pregnant women.

Quelle: Bundesministerium für Gesundheit, 2024Deutsche Apotheker Zeitung, 2024CDC, 2024.

How are STIs diagnosed during pregnancy?

STIs during pregnancy are diagnosed using specific tests. These include blood tests (e.g., for HIV, syphilis, and hepatitis B), cervical or vaginal swabs (e.g., for chlamydia and gonorrhea), and urine tests (e.g., for trichomoniasis). These tests are part of prenatal care and enable early treatment (MedlinePlus, 2024).

Discreet home tests such as the Basic 4 STI Test, the Chlamydia and Gonorrhea Test, or the STI Test Plus from Homed-IQ offer a convenient way to detect infections early. These tests can be easily performed at home and support timely treatment.

What treatment options are available for STIs during pregnancy?

Treatment during pregnancy depends on the STI. Some can be safely treated with antibiotics, while others may require antiviral medication or other measures to reduce transmission to the baby. Speak with your healthcare provider about the safest treatment option during pregnancy (CDC, 2025). 

Doxycycline is a commonly used broad-spectrum antibiotic for various bacterial infections, including several sexually transmitted infections. However, its use is generally contraindicated during pregnancy and breastfeeding (ECDC, 2026). 

How can you protect yourself from STIs during pregnancy?

During pregnancy, protecting your health and that of your unborn child is a top priority. With simple yet effective measures, you can significantly reduce the risk of sexually transmitted infections:

  • Use condoms: A reliable form of protection that significantly lowers the risk of infection.
  • Attend regular prenatal checkups: Early detection and treatment of infections protect both mother and child.
  • Get tested for STIs before or at the beginning of pregnancy: For a safe start to this special time.
  • Commitment and trust in your relationship: Reduces the risk of new infections and strengthens your bond.
  • Vaccinations before pregnancy: Vaccinations (for example against HPV) provide preventive protection against specific pathogens.
  • Open communication: Share your concerns and questions with your partner – together you can ensure your sexual health.

These measures support you in having a healthy pregnancy and giving your child the best possible start in life.

Frequently asked questions

How do STIs affect fertility, and what are the risks of untreated infections?

Untreated STIs can affect fertility in the long term by causing inflammation and permanent damage to the reproductive organs. The most common STIs are chlamydia and gonorrhea, which can lead to pelvic inflammatory disease (PID) and scarring of the fallopian tubes, increasing the risk of infertility and ectopic pregnancies. Other sexually transmitted diseases like Mycoplasma genitalium or HIV can also cause reproductive complications and infertility (CDC, 2024; Fertility Society of Australia, 2021).

Can I breastfeed my baby if I have an STI?

Whether breastfeeding is possible with an STI depends on the type of infection. Always consult your doctor to find the best solution for your individual situation.

  • STIs where breastfeeding is possible:
    With infections like chlamydia, gonorrhea, and HPV, breastfeeding is considered safe because they are not transmitted through breast milk. Breastfeeding is also safe with hepatitis B if the baby is vaccinated immediately after birth.
  • STIs where breastfeeding is not recommended:
    In the case of HIV, active syphilis, or herpes lesions on the breast, breastfeeding is not advised due to the potential risk of transmission. Breastfeeding is only possible if the baby does not come into contact with a lesion.

Sources: NIH, 2019; HIV.gov, 2023; CDC, 2024; CDC, 2023.

Summary

Sexually transmitted infections during pregnancy can endanger both the mother and the unborn child and may lead to miscarriage, developmental disorders, and birth complications. Routine testing and early treatment are essential to minimize these risks. Protective measures such as condom use, regular checkups, and open communication allow expectant parents to actively contribute to their sexual health.

Frequently asked questions

How reliable are the tests?

Our tests are analysed in an ISO 15189 accredited laboratory with the same equipment and protocols used by hospitals and GPs. The accuracy is comparable to a venous blood draw.

How quickly will I receive my results?

After receipt of your sample at the lab, you will receive your results within 1-2 working days in your personal, secure portal.

Are the tests really anonymous?

Yes, 100%. The packaging is plain, containing no indication of the contents. Your test is registered with an anonymous code. Only you have access to the results.

Sources

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    Bundesministerium für Gesundheit. (2024). Sexuell übertragbare Infektionen (STI) | BMG. Bundesministerium für Gesundheit. Retrieved December 30, 2024, from https://www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/s/sexuell-uebertragbare-infektionen-sti.html
  2. 2
    CDC. (2024, February 6). About STIs and Pregnancy | STI. CDC. Retrieved December 30, 2024, from https://www.cdc.gov/sti/about/about-stis-and-pregnancy.html
  3. 3
    Centers for Disease Control and Prevention (CDC). (2020). Protect Your Baby for Life – When a Pregnant Woman has Hepatitis B. CDC. Retrieved October 29, 2024, from https://www.cdc.gov/hepatitis-b/media/HepBPerinatal-ProtectWhenPregnant.pdf
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    Centers for Disease Control and Prevention (CDC). (2023). Hepatitis B or C Infections | Breastfeeding. CDC. Retrieved December 14, 2024, from https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/hepatitis-b-c.html?CDC_AAref_Val=https://www.cdc.gov/breastfeeding/breastfeeding-special-circumstances/maternal-or-infant-illnesses/hepatitis.html#
  5. 5
    Centers for Disease Control and Prevention (CDC). (2024). Infertility & STDs – STD Information from CDC. CDC Archive. Retrieved October 29, 2024, from https://archive.cdc.gov/www_cdc_gov/std/infertility/default.htm
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    Centers for Disease Control and Prevention (CDC). (2024, February 6). Herpes Simplex Virus and Breastfeeding | Breastfeeding special circumstances. CDC. Retrieved October 29, 2024, from https://www.cdc.gov/breastfeeding-special-circumstances/hcp/illnesses-conditions/herpes.html
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    Centers of Disease Control and Prevention (CDC). (2024, April 8). About Congenital Syphilis | Syphilis. CDC. Retrieved October 29, 2024, from https://www.cdc.gov/syphilis/about/about-congenital-syphilis.html
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    Deutsche Apotheker Zeitung. (2024, July 8). Wie Geschlechtskrankheiten während der Schwangerschaft das Ungeborene schädigen können. Deutsche Apotheker Zeitung. Retrieved December 30, 2024, from https://www.deutsche-apotheker-zeitung.de/news/artikel/2024/07/08/wie-geschlechtskrankheiten-waehrend-der-schwangerschaft-das-ungeborene-schaedigen-koennen
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    European Centre for Disease Prevention and Control. (2026). Public health considerations on the use of doxycycline for post-exposure prophylaxis for bacterial sexually transmitted infections in the EU/EEA. ECDC. https://www.ecdc.europa.eu/sites/default/files/documents/Doxycycline-prophylaxis-of-bacterial-STIs-in-the-EU-EEA.pdf
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    Fertility Society of Australia. (2021, April 1). Sexually transmitted infections (STIs). Fertility Society of Australia. Retrieved October 29, 2024, from https://www.fertilitysociety.com.au/wp-content/uploads/FSANZ-Sexually-transmitted-infections-STIs-April-2021.pdf
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    HIV.gov. (2023). Preventing Perinatal Transmission of HIV. HIV.gov. Retrieved October 29, 2024, from https://www.hiv.gov/hiv-basics/hiv-prevention/reducing-mother-to-child-risk/preventing-mother-to-child-transmission-of-hiv
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    Irshad, U., Mahdy, H., & Tonismae, T. (2023). HIV in pregnancy. In StatPearls. StatPearls Publishing. Retrieved October 29, 2024, from https://www.ncbi.nlm.nih.gov/books/NBK558972/
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    LaCour, D. E., & Trimble, C. (2012). Human papillomavirus in infants: Transmission, prevalence, and persistence. Journal of Pediatric and Adolescent Gynecology, 25(2), 93–97. https://doi.org/10.1016/j.jpag.2011.03.001
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    Mayo Clinic. (2023, September 8). Sexually transmitted diseases (STDs) – Symptoms and causes. Mayo Clinic. Retrieved October 29, 2024, from https://www.mayoclinic.org/diseases-conditions/sexually-transmitted-diseases-stds/symptoms-causes/syc-20351240
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    MedlinePlus. (2024, October 3). Sexually Transmitted Infection (STI) Tests. MedlinePlus. Retrieved December 30, 2024, from https://medlineplus.gov/lab-tests/sexually-transmitted-infection-sti-tests/
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    National Institutes of Health (NIH). (2019). Sexually Transmitted Infections, Pregnancy, and. ORWH. Retrieved December 30, 2024, from https://orwh.od.nih.gov/research/maternal-morbidity-and-mortality/information-for-women/sexually-transmitted-infections
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    World Health Organization (WHO). (2024, May 21). Sexually transmitted infections (STIs). World Health Organization (WHO). Retrieved October 29, 2024, from https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

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