title: Improvement in antenatal testing for sexually transmissible infections and blood-borne viruses in Western Australian hospitals, 2007 to 2010.
abstract: OBJECTIVE
  Antenatal testing for specified sexually transmissible infections (STIs) and blood-borne viruses (BBVs) is recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). In 2007, the Department of Health, Western Australia (DoHWA) issued an operational directive (OD) recommending universal testing for chlamydia and additional testing for women in the STI endemic regions of Western Australia (WA). To assess adherence to these guidelines, seven WA public hospitals were audited.
  
  
  METHODS
  Demographic details and testing information of the last 200 women who gave birth immediately before 30 June 2007 (baseline audit) and 30 June 2010 (follow-up audit) were obtained from each hospital's antenatal records.
  
  
  RESULTS
  Data from 2718 women who delivered at ≥36 weeks' gestation were analysed (baselinen=1353; follow-upn=1365). Testing at the first antenatal visit in accordance with the guidelines improved over time (RANZCOG: 68-74%; χ(2)-test = 13.96, d.f.=1, P<0.001; DoHWA OD: 12-40%; χ(2)-test = 279.71, d.f.=1, P<0.001). Retesting at 28-36 weeks' gestation in the STI endemic regions improved for chlamydia (3-10%; χ(2)-test = 17.40, d.f.=1, P<0.001) and gonorrhoea (3-7%; χ(2)-test=6.62, d.f.=1, P<0.05), but not for syphilis or HIV. Chlamydia prevalence was 3% and 8% among nonAboriginal and Aboriginal women, respectively.
  
  
  CONCLUSIONS
  The proportion of women delivering in WA public hospitals who had antenatal STI and BBV tests improved after publication and promotion of the OD.
authors.affiliation: Department of Health, Western Australia, Perth Business Centre, WA 6849, Australia.
authors.forename: Kellie S H
authors.initials: KS
authors.lastname: Kwan
authors.forename: Carolien M
authors.initials: CM
authors.lastname: Giele
authors.forename: Barry
authors.initials: B
authors.lastname: Combs
authors.forename: Donna B
authors.initials: DB
authors.lastname: Mak
mesh_terms: D000328:Adult; D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D016009:Chi-Square Distribution; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000379:methods*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D015995:Prevalence; D058996:Quality Improvement; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D018709:Statistics, Nonparametric; D014777:Virus Diseases / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D014904:Western Australia / Q000453:epidemiology