title: Heterogeneity in testing practices for infections during pregnancy: national survey across Switzerland.
abstract: OBJECTIVE
  Detection and treatment of infections during pregnancy are important for both maternal and child health. The objective of this study was to describe testing practices and adherence to current national guidelines in Switzerland.
  
  
  METHODS
  We invited all registered practicing obstetricians and gynaecologists in Switzerland to complete an anonymous web-based questionnaire about strategies for testing for 14 infections during pregnancy. We conducted a descriptive analysis according to demographic characteristics.
  
  
  RESULTS
  Of 1138 invited clinicians, 537 (47.2%) responded and 520 (45.6%) were eligible as they are currently caring for pregnant women. Nearly all eligible respondents tested all pregnant women for group B streptococcus (98.0%), hepatitis B virus (HBV) (96.5%) and human immunodeficiency virus (HIV) (94.7%), in accordance with national guidelines. Although testing for toxoplasmosis is not recommended, 24.1% of respondents tested all women and 32.9% tested at the request of the patient. Hospital doctors were more likely not to test for toxoplasmosis than doctors working in private practice (odds ratio [OR] 2.52, 95% confidence interval [CI] 1.04-6.13, p = 0.04). Only 80.4% of respondents tested all women for syphilis. There were regional differences in testing for some infections. The proportion of clinicians testing all women for HIV, HBV and syphilis was lower in Eastern Switzerland and the Zurich region (69.4% and 61.2%, respectively) than in other regions (range 77.1-88.1%, p <0.001). Most respondents (74.5%) said they would appreciate national guidelines about testing for infections during pregnancy.
  
  
  CONCLUSIONS
  Testing practices for infections in pregnant women vary widely in Switzerland. More extensive national guidelines could improve consistency of testing practices.
authors.affiliation: Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Karoline
authors.initials: K
authors.lastname: Aebi-Popp
authors.affiliation: Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Kahlert
authors.affiliation: Department of Infectious Diseases, Bern University Hospital, University of Bern, Switzerland.
authors.forename: Andri
authors.initials: A
authors.lastname: Rauch
authors.affiliation: Department of Obstetrics and Gynaecology, Bern University Hospital, Switzerland.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Mosimann
authors.affiliation: Department of Obstetrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Baud
authors.affiliation: Institute of Social and Preventive Medicine, University of Bern, Switzerland.
authors.forename: Nicola
authors.initials: N
authors.lastname: Low
authors.affiliation: Department of Obstetrics and Gynaecology, Bern University Hospital, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Surbek
mesh_terms: D000328:Adult; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011296:Prenatal Diagnosis / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013557:Switzerland