Abstract
Objective
This study sought to determine the proportion of pregnant women who are tested for
gonorrhea and chlamydia as part of their prenatal care and to examine patient and
provider factors affecting testing rates.
Methods
The study investigators conducted a retrospective chart review of all patients who
delivered at St. Michael's Hospital, an urban tertiary care centre in Toronto, Ontario,
between November 2015 and April 2016. Rates of testing and the prevalence of positive
test results for gonorrhea and chlamydia were calculated. Chi-square tests were used
to compare rates of testing among different types of prenatal care providers (obstetricians,
maternal-fetal medicine specialists, family practitioners, midwives) and to determine
whether testing rates were affected by patient demographics or characteristics. This
study was a Canadian Task Force Classification II-2 retrospective cohort study.
Results
Of the 1315 women who delivered at St. Michael's Hospital during the study period,
1220 met inclusion criteria for the study. Of these women, 186 (15.3%) were not tested
for gonorrhea and chlamydia during their pregnancy. There were 11 cases of chlamydia
(1.1%) and no cases of gonorrhea. Testing rates were not affected by patient demographic
variables or obstetrical history. Midwives and family physicians had the highest testing
rates among the provider groups: 93.8% and 91.4%, respectively. Generalist obstetricians
tested 88.5% of their patients. Maternal-fetal medicine specialists had a significantly
lower rate of testing than the other provider groups, at 64.8% (P < 0.0001).
Conclusions
Fifteen percent of women were not tested for gonorrhea and chlamydia during the study
period even though testing was recommended as part of routine prenatal care. Testing
rates varied among providers, and strategies to improve these rates need to be explored.
Résumé
Objectif
Cette étude visait à déterminer la proportion de femmes enceintes qui subissent un
dépistage de la gonorrhée et de la chlamydia dans le cadre de leurs soins prénataux
et à examiner les facteurs relatifs aux patientes et aux fournisseurs influençant
cette proportion.
Méthodologie
Les chercheurs ont effectué un examen rétrospectif des dossiers de toutes les patientes
qui ont accouché à l'Hôpital St. Michael's, un centre de soins tertiaires en milieu
urbain à Toronto (Ontario), entre novembre 2015 et avril 2016. Le taux de dépistage
de la gonorrhée et de la chlamydia et la prévalence de résultats positifs ont été
calculés. Des tests du chi carré ont été utilisés dans le but de comparer le taux
de dépistage selon les types de fournisseurs de soins prénataux (obstétriciens, spécialistes
en médecine fœtomaternelle, omnipraticiens, sages-femmes) et de déterminer si le taux
était influencé par les caractéristiques démographiques ou autres des patientes. Il
s'agissait d'une étude de cohorte rétrospective conforme à la classification II-2
du Groupe d'étude canadien.
Résultats
Des 1315 femmes qui ont accouché à l'Hôpital St. Michael's durant la période à l'étude,
1 220 respectaient les critéres d'inclusion de l'étude. Parmi celles-ci, 186 (15,3 %)
n'avaient pas subi de dépistage de la gonorrhée ou de la chlamydia durant leur grossesse.
Il y avait 11 cas de chlamydia (1,1 %) et aucun cas de gonorrhée. Le taux de dépistage
n'était pas influencé par les caractéristiques démographiques ou les antécédents obstétricaux
des patientes. Les sages-femmes et les médecins de famille présentaient les plus hauts
taux de dépistage : 93,8 % et 91,4 %, respectivement. Les obstétriciens généralistes
soumettaient au dépistage 88,5 % de leurs patientes. Quant aux spécialistes en médecine
fœtomaternelle, leur taux de dépistage était beaucoup plus faible que celui des autres
groupes de fournisseurs, soit 64,8 % (P < 0,0001).
Conclusions
Durant la période à l'étude, 15 % des femmes n'ont pas subi de dépistage de la gonorrhée
et de la chlamydia, même si celui-ci est recommandé dans le cadre des soins prénataux
habituels. Le taux de dépistage variait selon les fournisseurs, et des stratégies
pour l'augmenter devront être explorées.
Key Words
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Article info
Publication history
Published online: April 03, 2019
Accepted:
February 7,
2019
Received:
October 28,
2018
Footnotes
Competing interests: The authors declare that they have no competing interests.
Each author has indicated that they meet the journal's requirements for authorship.
This work was presented at the 73rd Annual Clinical Meeting of the Society of Obstetricians and Gynaecologists of Canada (SOGC), June 22, 2017, Ottawa, ON.
Identification
Copyright
© 2019 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
