title: Chlamydia screening in pregnancy in Australia: integration of national guidelines into clinical practice and policy.
abstract: BACKGROUND
  Chlamydia trachomatis is the most common reportable infection in Australia. Since 2006, the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) have recommended chlamydia screening in pregnant women aged <25 years.
  
  
  OBJECTIVE
  To assess clinical uptake and policy integration of the 2006 RANZCOG recommendation on chlamydia testing in pregnant women aged <25 years.
  
  
  METHODS
  A mixed method approach was used involving a literature review, a survey of obstetricians and gynaecologists, and survey of hospital managers from April 2010 to May 2010.
  
  
  RESULTS
  Of the 1644 participating RANZCOG Fellows, Trainees, and Diplomates, 21.2% reported universal screening for pregnant women <25 years (25% of primary care clinicians, 23% of those working in the public hospital sector, 16% of those working in both public and private hospitals, and 13% of those in private hospitals or private practice). There was a strong association between members who agreed with the guideline and offering universal screening to pregnant women aged <25 years (adjusted odds ratio = 17.1, 95% CI: 6.0-49.2, P < 0.01). Of the 143 participating hospital managers who completed the hospital policy questionnaire; 20% reported that their hospital had a formal screening guideline. There were two national and four state/local policy documents recommending chlamydia screening in pregnancy.
  
  
  CONCLUSIONS
  This study shows low uptake of chlamydia screening of young pregnant women by RANZCOG Fellows, Trainees, and Diplomates involved in antenatal care and highlights the need for national clinical leadership regarding screening for chlamydia among pregnant women aged <25 years.
authors.affiliation: National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Zhuoyang
authors.initials: Z
authors.lastname: Li
authors.forename: Marcus
authors.initials: M
authors.lastname: Chen
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.forename: Jeremy
authors.initials: J
authors.lastname: Oats
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Sullivan
mesh_terms: D001315:Australia; D002690:Chlamydia Infections / Q000175:diagnosis*; D005260:Female; D006176:Gynecology; D019538:Health Care Surveys; D006740:Hospital Administrators; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D009774:Obstetrics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011295:Prenatal Care / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Australia; Chlamydia trachomatis; antenatal screening; chlamydia; perinatal care