Abstract
BackgroundIn pregnancy, untreated chlamydia infection has been associated with adverse outcomes for both mother and infant. Like most women, pregnant women infected with chlamydia do not report genital symptoms, and are therefore unlikely to be aware of their infection. The aim of this study was to determine the acceptability of screening pregnant women aged 16-25 years for chlamydia as part of routine antenatal care.MethodsAs part of a larger prospective, cross-sectional study of pregnant women aged 16-25 years attending antenatal services across Melbourne, Australia, 100 women were invited to participate in a face-to-face, semi structured interview on the acceptability of screening for chlamydia during pregnancy. Women infected with chlamydia were oversampled (n = 31).ResultsWomen had low levels of awareness of chlamydia before the test, retained relatively little knowledge after the test and commonly had misconceptions around chlamydia transmission, testing and sequelae. Women indicated a high level of acceptance and support for chlamydia screening, expressing their willingness to undertake whatever care was necessary to ensure the health of their baby. There was a strong preference for urine testing over other methods of specimen collection. Women questioned why testing was not already conducted alongside other antenatal STI screening tests, particularly in view of the risks chlamydia poses to the baby. Women who tested positive for chlamydia had mixed reactions, however, most felt relief and gratitude at having had chlamydia detected and reported high levels of partner support.ConclusionsChlamydia screening as part of routine antenatal care was considered highly acceptable among young pregnant women who recognized the benefits of screening and strongly supported its implementation as part of routine antenatal care. The acceptability of screening is important to the uptake of chlamydia screening in future antenatal screening strategies.
Highlights
In pregnancy, untreated chlamydia infection has been associated with adverse outcomes for both mother and infant
In this study we found that chlamydia screening, as part of routine antenatal care, was considered highly acceptable among young pregnant women, who were strongly motivated by concern for the health of their baby and willing to undertake whatever care was necessary to ensure the safety of their baby
Chlamydia testing using urine specimens was highly acceptable among young pregnant women in this study
Summary
In pregnancy, untreated chlamydia infection has been associated with adverse outcomes for both mother and infant. Pregnant women infected with chlamydia do not report genital symptoms, and are unlikely to be aware of their infection. In pregnancy, untreated chlamydia infection has been associated with adverse maternal and neonatal outcomes, including increased risk of miscarriage, postpartum endometritis, premature rupture of the membranes and preterm labour for the mother, and a risk of low birth weight and transmission during the delivery to the neonate, leading to conjunctivitis and pneumonitis [4,5,6,7,8]. In a recent Australian study by Chen et al (2009), the prevalence of chlamydia in a cross section of pregnant women aged 16 to 20 years attending antenatal services across Melbourne was 6.4% [12]
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