Screening for Chlamydia trachomatis in pregnancy: a retrospective analysis in a German urban area.
OBJECTIVE
Chlamydia trachomatis infection is the most common bacterial sexual transmitted disease. Nearly 75% of all cases appear clinically unapparent and can cause, especially when getting chronically, infertility. Regarding pregnancy, a nationwide screening for C. trachomatis was established since April 1995. The aim of this study was to determine the percentage of tested patients throughout these 7 years to evaluate the execution of the German guidelines.


METHODS
Between 2001 and 2007, 12,865 patients were evaluated retrospectively concerning a Chlamydia trachomatis testing.


RESULTS
A test was performed for chlamydial infection in 10,088 patients (78.4%). 65 pregnant patients (0.5%) out of 1,008 tested patients were positive for Chlamydia trachomatis. The part of tested patients was rising significantly from 2001 to 2007. In 2001, 68.3% pregnant patients were tested. The number of screened patients increased continuously up to 85.2% in 2007 (p < 0.001). The percentage of positive tested patients ranged from 0.27% in 2003 to 0.74% in 2005 (mean 0.50%).


CONCLUSIONS
Since 1995, a screening for Chlamydia trachomatis has to be offered to every pregnant woman according to the German guidelines. The number of tested pregnant patients was rising from 68.3 to 85.2% within the evaluated 7 years, which would be a necessary and welcome trend. Interestingly, the mean prevalence of 0.5% of positive tested patients in this analysed urban population seems to be very low. An explanation might be the usage of the point-of-care (POC) tests and its low sensitivity. Testing by nucleic acid amplification might lead to a higher detection rate. Although the awareness concerning Chlamydia trachomatis testing during pregnancy seems to have been changed over the recent years, these data are still dissatisfactory.
Weissenbacher
Tobias M
TM
First Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University, Maistrasse 11, 80337 Munich, Germany.
Kupka
Markus S
MS
Kainer
Franz
F
Friese
Klaus
K
Mylonas
Ioannis
I
D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology; D002692:Chlamydia trachomatis; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D019983:Guideline Adherence; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000453:epidemiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis* / Q000453:epidemiology; D014505:Urban Population; D014600:Utilization Review