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Infectious Diseases in Obstetrics and Gynecology
Volume 6 (1998), Issue 3, Pages 116-122
Initial and Repeat Screening for Chlamydia trachomatis During Pregnancy
1Departmet of Obtetrics and Gynecolog, University of North Carolina at Chapel Hill, 214 MacNider Building, Chapel Hill 27599-7570, NC, USA
2Department of Obstetrics and Gynecology, University of Florida at Jacksonville, Jacksonville, FL, USA
3Department of Gynecology and Obstetrics, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA
Received 6 February 1998; Accepted 22 July 1998
Copyright © 1998 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives: 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 highschool 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. Infect.