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Rates of Chlamydia trachomatis testing and chlamydial infection in pregnant women.

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.