Chlamydial and gonococcal testing during pregnancy in the United States.

Quest Diagnostics, West Norriton, PA, USA.
American journal of obstetrics and gynecology (Impact Factor: 3.28). 04/2012; 207(1):55.e1-8. DOI: 10.1016/j.ajog.2012.04.027
Source: PubMed

ABSTRACT The objective of the study was to estimate the rates of testing, prevalence, and follow-up testing for chlamydial and gonococcal infection in a nationally based population that is comparable with the US pregnant population in terms of age and race.
We extracted laboratory results for 1,293,423 pregnant women tested over a 3-year period.
During pregnancy, 59% (761,315 of 1,293,423) and 57% (730,796 of 1,293,423) of women were tested at least once for Chlamydia trachomatis or for Neisseria gonorrhoeae, respectively. Of those women tested, 3.5% (26,437 of 761,315) and 0.6% (4605 of 730,796) tested positive for chlamydial and gonococcal infection, respectively, at least once during pregnancy. Of those women who were initially positive for the given infection, 78% (16,039 of 20,489) and 76% (2610 of 3435) were retested, of whom 6.0% (969 of 16,039) and 3.8% (100 of 2610) were positive on their last prenatal test for C trachomatis and N gonorrhoeae, respectively.
Many pregnant women are not tested for C trachomatis and N gonorrhoeae despite recommendations to test. Follow-up testing to monitor the effectiveness of treatment is also not always performed.

1 Bookmark
  • [Show abstract] [Hide abstract]
    ABSTRACT: Infection is a major cause of neonatal death in developing countries. This review investigates whether host iron status affects the risk of maternal and/or neonatal infection, potentially contributing to neonatal death, and summarizes the iron acquisition mechanisms described for pathogens causing stillbirth, preterm birth, and congenital infection. In vitro evidence shows that iron availability influences the severity and chronicity of infections that cause these negative outcomes of pregnancy. In vivo evidence is lacking, as relevant studies of maternal iron supplementation have not assessed the effect of iron status on the risk of maternal and/or neonatal infection. Reducing iron-deficiency anemia among women is beneficial and should improve the iron stores of babies; moreover, there is evidence that iron status in young children predicts the risk of malaria and, possibly, the risk of invasive bacterial diseases. Caution with maternal iron supplementation is indicated in iron-replete women who may be at high risk of exposure to infection, although distinguishing between iron-replete and iron-deficient women is currently difficult in developing countries, where a point-of-care test is needed. Further research is indicated to investigate the risk of infection relative to iron status in mothers and babies in order to avoid iron intervention strategies that may result in detrimental birth outcomes in some groups of women.
    Nutrition Reviews 08/2013; 71(8):528-40. · 4.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sexually transmitted infections (STI) occur during pregnancy and can have serious consequences for women and infants. National guidelines include recommendations for STI screening in all pregnant women; however women continue to be underscreened, and risks related to infection during pregnancy persist. Nurses caring for women of childbearing age should be aware of screening guidelines and approaches for testing. This column reviews two recent studies: The first examines compliance with recommended prenatal STI testing and the second highlights a novel concept to reduce the female-gender-specific approach to STI testing during pregnancy.
    Nursing for Women s Health 02/2014; 18(1):67-72.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Received: This study was carried out to determine the prevalence of the bacterial agents Chlamydia trachomatis (C. trachomatis), Neisseria gonorrhoeae (N. gonorrhoeae), Mycoplasma hominis (M. hominis) and Ureaplasma urealyticum (U. urealyticum) and the conditions which may play a role in the development of female infertility, in the county of Iapi in North-Eastern Romania. Cervical and blood samples were collected from 176 infertile women and 45 pregnant women in the third trimester. Classical methods and real time PCR were applied to each cervical sample to detect the presence of these sexually transmitted microorganisms; the ELISA method was applied to blood samples to detect C. trachomatis antibodies (IgA, IgM and IgG). The proportion of C. trachomatis IgG was significantly higher in the infertile group (23.8%) than in the pregnant group (4.4%), p < 0.05. For C. trachomatis antigen (Ag) and N. go-norrhoeae Ag no differences were observed between the two groups. The prevalence of mycoplasma genital infections was higher in the pregnant group (U. urealyticum – 53.3% and M. hominis – 20%) than in the infertile group (U. urealyticum – 39.7% and M. hominis – 7.3%). Higher rate of co-infection with C. trachomatis and mycoplasma were observed among the infertile women (25.7%) than among the pregnant women (7.7%). This combination could be involved in the appearance of pelvic inflammatory disease (PID) and its sequela, including infertility. C. trachomatis IgG determination still remains the gold standard for the diagnosis of PID and should be used as a screen-ing test for the prediction of tubal damage in infertile women. In view of the large number of cases involving the co-existence of genital infections with C. trachomatis, 1217-8950/$20.00 © 2013 Akadémiai Kiadó, Budapest


Available from
May 15, 2014