Screening for sexually transmitted infections in pregnancy at Middlemore Hospital, 2009

Aims To determine the screening rate for, and the prevalence rate of, sexually transmitted infections (STIs) in pregnancy at Middlemore Hospital. Method A list of all 6795 women who had a baby at Middlemore Hospital in 2009 was provided by the hospital's information systems. Details of the women including their swab results were then obtained from the Healthware and Web-Eclair databases. Comparison of screening and STI rates by categorical variables (Lead Maternity Carer (LMC), age group and ethnicity) was carried out using Chi-square statistics. Univariable and multivariable odds ratios were estimated using unconditional logistic regression. Results Only 4635 (64.3%) of women were screened in pregnancy for an STI. There was a significant difference in rates of testing by LMCs, with independent maternity providers less likely to carry out a swab than the District Health Board (DHB) providers (71.3% vs 54.0%, p<0.0001). A higher proportion of Maori and Pacific women were screened compared to other groups and younger women were screened more compared to older women. Of those women screened, 8.2% had chlamydia, 2.2% had trichomonas and 0.2% had gonorrhoea. There were higher rates of chlamydia and trichomonas seen in both Maori and Pacific women in comparison to European and Asian women. There was a pattern of decreasing STI rate with an increase in maternal age. Conclusion Screening for STIs in pregnancy in Middlemore Hospital is low and does not meet the requirements of the Ministry of Health which requires all women to be screened. The STI prevalence rate is high especially in young Pacific and Maori women. Education of both women and maternity providers is important in prevention and detection of STIs in pregnancy.