Screening for asymptomatic urogenital Chlamydia trachomatis infection at a large Dublin maternity hospital: results of a pilot study.

Abstract

There are currently no Irish guidelines on screening for Chlamydia trachomatis infection in pregnancy. Prevalence rates in the antenatal population are not known which has prevented the development of screening recommendations for this group. The objective of this study was to determine the prevalence of asymptomatic urogenital C. trachomatis infection in young women attending for care at a large maternity hospital. All patients aged 25years and under attending the Hospital between December 2011 and December 2013 were offered screening for urogenital C. trachomatis infection. Nucleic acid amplification testing of the C. trachomatis cryptic plasmid was performed on either endocervical swabs or first void urine samples. There were 2687 women tested for C. trachomatis infection, 83.4% (2241/2687) through the antenatal clinics, 7.1% (193/2687) through the gynaecology clinic, and 9.4% (253/2687) through the emergency department. The rate of a positive test result was 5.6% (151/2687) overall. The rates in women ages 16-18, 19-21 and 22-25years were 9.1% (31/340), 6.5% (50/774) and 4.4% (69/1561), respectively. A positive test result was more likely in those who were unemployed (p=0.04), those who were Irish (p=0.03) and those who were unmarried (p<0.01). There were no cases of neonatal C. trachomatis infection in babies born to mothers who were screened in early pregnancy. The prevalence rate of detected C. trachomatis infection was 5.6% in the study population. Screening of antenatal patients may have a role in preventing vertical transmission of infection to the neonate.