Clap if your momma loves you

June 8, 2007 6:24 AM

I learned in various sex-ed classes that some STD's, if undiagnosed or improperly treated during a pregnancy, can cause blindness in infants. Can you tell me more about this?

Which diseases do this? At what point during a pregnancy could it be determined that the baby would be blind, or would one only find out after?

Is it possible for the mother to be infected with something that provides her only minor or no discomfort, that isn't identified as an STD until after the damage is done to her baby?

posted by BE ADEQUITE to health & fitness (19 comments total)

I can't answer the portions of your question which obviously are most important to you, but I can tell you which common STDs have this risk of the pregnant mother with an STD causing blindness in the baby. They are gonorrhea, chlamydia, and syphilis. Syphilis is the most severe and, I think (though I could be wrong) is the most likely to be symptomless, or nearly so, in the mother yet very dangerous to the child.
posted by Ethereal Bligh at 6:46 AM on June 8, 2007

Gonorrhoea causes blindness in infants. Some places they routinely treat a newborn's eye with an antibiotic as a preventive. The baby is blinded during pregnancy but rather the exposure in the birth canal can cause them to be blinded.
posted by Mitheral at 6:49 AM on June 8, 2007

Syphilis could do this, although testing for it is now standard practice in prenatal care, for this very reason. My understanding is that the blindness wouldn't normally develop, though, until the disease has progressed to late stage in the child, which can take 10-20 years.
posted by phoenixy at 6:50 AM on June 8, 2007

That is the baby is NOT blinded during pregnancy but as a result of exposure during the birthing process.
posted by Mitheral at 6:50 AM on June 8, 2007

Gonorrhea can cause blindness in infants, but only if the bacteria enters the baby's eyes during childbirth and the resulting infection is not treated.

Here's a page on gonorrhea if you are interested; information about infant blindness toward the bottom.

This may happen with other bacterial STDs, but I've only ever heard about in the context of gonorrhea.
posted by bluenausea at 6:51 AM on June 8, 2007

Add HIV to EB's list. Syphilis and HIV can cross the placenta during pregnancy, the others infect the infant during delivery, causing a conjuncitivitis that can lead to blindness. This page about a new treatment says chlamydia is the leading infection.
posted by mediareport at 6:56 AM on June 8, 2007

Sorry, posted prematurely.

None of these STDs are going to cause infant blindness unless the kid contacts infected tissue as its moving through the birth canal. Inside the uterus, it's quite safe -- unless the uterus is infected, but if it were, you could probably not maintain a pregnancy.

So you only really need to worry about transmission during childbirth; advisable to get tested/treated before labor (preferably before pregnancy -- some of the treatments might not be so good for the fetus).
posted by bluenausea at 6:56 AM on June 8, 2007

Er, conjunctivitis.
posted by mediareport at 6:56 AM on June 8, 2007

Er, yes, sorry, HIV and syph definitely do cross placenta, I was just thinking about STDs that would cause infant blindness, and I can't remember any that are are placenta-crossers.
posted by bluenausea at 7:07 AM on June 8, 2007

Herpes can cause blindness in infants, as well as a host of other maladies.
posted by chlorus at 7:28 AM on June 8, 2007

The only thing that causes blindness in infants is gonorrhea, to my knowledge, and as others have said, the issue occurs during birth. When my kids were born they were both immediately given eyedrops (back in the dim dark days this was silver nitrate; nowadays I believe it's something much less caustic) against this possibility but that was a while back and I think it's fallen out of favor. If you're worried, though, ask your doctor to revive it. Noone asked me about it - they just did it. It didn't seem to bother my babies - granted it's hard to tell when they're already shrieking from being born. Herpes also can be a problem during birth; if a woman is having an active herpes flare up her doctor will most likely recommend a Caesarean.

Doing a full STD scan before pregnancy is, of course, a really good idea, but there's no reason it can't be done during pregnancy either. In the US at least you can go get one done at pretty much any county health department for free.
posted by mygothlaundry at 7:36 AM on June 8, 2007

“The only thing that causes blindness in infants is gonorrhea, to my knowledge, and as others have said, the issue occurs during birth.”

If you read the other comments in this thread, I'd have expected you not to so blithely assert (even to your knowledge) that only gonorrhea can cause blindness in infants. Chlamydia definitely can—it's a leading cause of blindness, in general. There are probably others. Pheonixy seems to be right that syphilis won't cause blindness until the child is older, even though it can cause stillbirths and, when an infant is carried to term, other symptoms.
posted by Ethereal Bligh at 7:49 AM on June 8, 2007

Anyone who's been through the Ellis Island tour has seen the old black and white photographs of medically unfit emigrés, returned to their country of origin with their diagnosis chalked on their back. The large "CT," diagnosed on conjunctival exam, stood for "Chlamydia trachomatis." Before antibiotics there was no help for these people - they would go blind as their corneas became ulcerated and then infiltrated with blood vessels during the scarring process.

The Hutchinson triad of congenital syphilis (syphilis acquired in utero) includes interstitial keratitis, which is essentially the same corneal process described above. Deafness due to nerve damage and peg teeth are the other two parts of this syndromic triad.

As far as I know the gonorrheal blindness, prevented by silver nitrate eyedrops at birth, is only acquired in the birth canal.

The "TORCH" infections can also produce blindness in utero, for various reasons; of them, herpes and hepatitis can be sexually acquired.
posted by ikkyu2 at 8:33 AM on June 8, 2007

You seem to have an urgent concern about this. If think you might be or are planning on getting pregnant, go to your doctor or Planned Parenthood and get a full STD screening done. It's a responsible precaution to take -- if you don't feel comfortable with your doctor on this, the PP folks tend to be nonjudgemental about this sort of thing, keep the results confidential, and actively promote that they do STD testing.
posted by yohko at 8:41 AM on June 8, 2007

Ikkyu, just to clarify, are you saying that an infection such as hep b can result in an infant actually being born blind or otherwise disabled, as opposed to contracting an infection at birth that will later result in problems?

At what stage could that become apparent in fetal development?

Don't be concerned, I'm harboring neither offspring nor STD's. This is for a writing project, and I'm wondering if a woman who hasn't received adequate healthcare could find out during her pregnancy that her baby would be born blind or disabled as the result of an STD. Bonus points if it was a condition she could have remained more or less oblivious to up until that time.
posted by BE ADEQUITE at 9:10 AM on June 8, 2007

Neonate conjunctivitis can be caused by exposure to STDs in the birth canal (commonly gonorrhea or chlamydia, less commonly by genital/oral herpes viruses) and by non-sexually transmitted bacteria that live in the birth canal. Less threatening is conjunctivitis caused by a blocked tear duct or by irritation to the antibiotic eyedrops given in response to the infection risks caused by STDs.

Many states require the eyedrops regardless of the health of the mother. In other states, women can request a full STD work up with their routine prenatal pap smear and use those results to request that eyedrops not be administered. It's my opinion that many of the more restrictive rules regarding newborn care are in reaction to the number of women who can't afford, can't access or choose not to have adequate prenatal care. This leads to "over-treatment" approach to both pregnancy and newborn care.
posted by rosebengal at 10:29 AM on June 8, 2007

Also, don't forget that women can have sex *during* pregnancy. This means that they can contract a variety of diseases that no one knows about until she gets tested, and if she doesn't get tested before the baby is born, it might be a problem. For instance, a women could get herpes during her last trimester, and be experiencing an infection during labor. If she doesn't go to a hospital for the birth, like perhaps if the baby is born at home with no midwife or doula, she could still spread these diseases to her child during birth.
posted by nursegracer at 2:33 PM on June 8, 2007

Adequite, I don't know all the problems that hep B can cause if you contract it in utero, but it can definitely result in the kid being born with major problems (atresia, i.e. non-formation, of the bile duct, for example, which is catastrophic.) I don't know whether it can cause blindness.

If you were to Google things like Torch infections and "congenital ", you might learn a lot more about it - that link is pretty good. The torch infections all cause problems during embryofetal development - by the time birth rolls around, the damage has been done. Rubella (deafness) and toxoplasmosis (blindness, brain lesions) are some of the major players; congenital toxo comes from Mom cleaning out the kitty's litter box, so it's usually 100% asymptomatic.
posted by ikkyu2 at 6:46 PM on June 8, 2007

um, that was supposed to say, "congenital [disease name]."
posted by ikkyu2 at 6:46 PM on June 8, 2007