Chlamydia trachomatis screening in pregnancy in New Zealand: translation of national guidelines into practice

Abstract

INTRODUCTION: Chlamydia trachomatis (C. trachomatis) is a common sexually transmitted infection (STI), and routine antenatal screening to reduce the risk of vertical transmission is recommended in New Zealand (NZ). AIM: To determine the proportion of pregnant women who have been screened for C. trachomatis in selected hospitals since the 2008 NZ Ministry of Health Chlamydia Management Guidelines were published, and to examine variation by age and ethnicity. METHODS: Clinical audits were undertaken at four NZ hospitals, using electronic databases to determine if C. trachomatis screening had occurred. RESULTS: Only 24%, 31%, 35% and 61% of pregnant women were screened in Tauranga (2010), Auckland (2013), Waikato (2013) and Middlemore (2011) hospitals, respectively. DISCUSSION: Despite increases in the proportion of pregnant women screened in Auckland and Middlemore compared to pre-2008, and higher proportions of young women and Maori women screened, overall antenatal screening for C. trachomatis remains suboptimal. Several strategies are presented to support universal screening in pregnancy, as recommended by the NZ Ministry of Health. KEYWORDS: Chlamydia trachomatis; mass screening; medical audit; pregnancy