Initial and repeat screening for Chlamydia trachomatis during pregnancy.
OBJECTIVE
The objective of this study is to determine the prevalence of Chlamydia trachomatis and risk factors for positive repeat tests in a high-risk population presenting for early prenatal care.


METHODS
We completed a retrospective cohort study of 2,484 women who initiated prenatal care prior to 20 weeks gestation, delivered, and received testing for cervical C. trachomatis at Grady Memorial Hospital or a Grady-affiliated clinic between July 1, 1993 and December 31, 1994. We calculated adjusted odds ratios (OR) for selected risk factors for a positive initial test and for a positive subsequent test after an initial negative test.


RESULTS
The prevalence of C. trachomatis was 14.8%. At initial testing, 10.4% of the women were positive. If the initial test was negative, 5.7% had a positive subsequent test; but if the initial test was positive, 32.0% had a positive subsequent test (P < 0.001). The variables significantly and independently associated with a positive initial test were black race/ethnicity, age less than 25, unmarried, and less than a high-school education (adjusted OR of 1.66, 3.53, 2.18, and 1.81, respectively). Variables significantly and independently associated with a positive subsequent test after a negative initial test were white race/ethnicity, black race/ethnicity, age less than 25, and less than a high-school education (adjusted OR 8.69, 7.77, 4.12, and 2.27, respectively).


CONCLUSIONS
In our inner-city population, most pregnant women have risk factors suggesting the need to rescreen for C. trachomatis in the second half of pregnancy.
Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill 27599-7570, USA.
A D
AD
Allaire
J F
JF
Huddleston
W L
WL
Graves
L
L
Nathan
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D015331:Cohort Studies; D005260:Female; D005831:Genital Diseases, Female / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008403:Mass Screening; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D011295:Prenatal Care; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors