Rates of Chlamydia trachomatis testing and chlamydial infection in pregnant women

Abstract

Aims: To determine the rate of Chlamydia trachomatis testing and chlamydial infection in pregnancy (by auditing a community medical laboratory database).

Methods: Data for women registered with a maternity care provider between 1999 and 2002 were matched with a community medical laboratory database for patients who met one of three criteria: tested for C. trachomatis, or had a first or second antenatal blood screen at that laboratory. The rate of C. trachomatis testing and of chlamydial infection was then calculated in this sample.

Results: The overall rate of C. trachomatis testing for 6614 matched deliveries was 37.5%, with 4.8% of those tests positive for chlamydial infection. The rate of testing differed significantly between age-bands (p<0.0001), and by ethnicity (p<0.0001). The rate of infection showed a significant effect of age (p<0.0001) and ethnicity (p<0.0001). Maori and Pacific women, and those under the age of 25 years, had the highest rates--both of testing and of C. trachomatis infection.

Conclusions: There is a high rate of maternal C. trachomatis in under 25-year-olds, and in Maori and Pacific women, together with incomplete testing for the infection in pregnancy. This highlights the need to instigate routine testing for C. trachomatis in pregnancy--to reduce the significant, yet preventable, morbidity associated with chlamydia in both the mother and the neonate.