Abstract
Objective
This study sought to provide a 14-year overview of serological results from a provincial
prenatal screening program.
Methods
Prenatal screening data from August 2002 to December 2016 were extracted from the
Alberta Public Health Laboratory (ProvLab) Information system. Data were analyzed
by year, communicable disease marker, test result, and maternal age category. The
age-stratified proportion of seropositive results for hepatitis B virus, human immunodeficiency
virus, and syphilis was determined, and the proportion of seronegative results was
determined for rubella and varicella. The Mann Kendall Trend Test was performed to
identify significant temporal trends in the results (Canadian Task Force Classification
II-2).
Results
In total 821 910 prenatal specimens were examined. Overall, the proportion of prenatal
specimens positive for hepatitis B virus showed a slight statistically significant
upward trend from 0.50% in 2003 to 0.58% in 2016 (P = 0.03). The proportion of positive human immunodeficiency virus prenatal specimens
showed no significant trend over the study period. The proportion of positive syphilis
specimens increased from 2006 to 2008 (0.07% to 0.21%; P < 0.0001) and stayed relatively constant until a decrease began in 2015. The proportion
of seronegative specimens for varicella and rubella showed a significant upward trend
of 0.48% per year (P < 0.01) and 0.88% per year (P < 0.01), respectively.
Conclusion
The Alberta Prenatal Screening Program for Selected Communicable Diseases presents
a unique data set that allows us to look at screening results on a provincial level.
Trends in results are reflective of communicable disease trends in the general population
and should be monitored for effective infectious disease management of the maternal
and newborn population.
Résumé
Objectif
Cette étude visait à fournir une synthèse des résultats sérologiques recueillis pendant
14 années dans le cadre d'un programme provincial de dépistage prénatal.
Méthodologie
Les données de dépistage prénatal recueillies entre août 2002 et décembre 2016 ont
été extraites du système d'information du laboratoire de santé publique de l'Alberta
(ProvLab). Les données ont été analysées par année, marqueur de maladie transmissible,
résultat d'analyse et catégorie d'âge maternel. On a déterminé la proportion de résultats
séropositifs par tranche d'âge pour le virus de l'hépatite B, le virus de l'immunodéficience
humaine et la syphilis, ainsi que la proportion de résultats séronégatifs pour la
rubéole et la varicelle. Le test de tendance de Mann-Kendall a permis de relever des
tendances temporelles significatives dans les résultats (classification du Groupe
d'étude canadien n° II-2).
Résultats
Au total, 821 910 échantillons prénataux ont été examinés. Dans l'ensemble, la proportion
d'échantillons prénataux séropositifs pour l'hépatite B a affiché une légère hausse
statistiquement significative en passant de 0,50 % en 2003 à 0,58 % en 2016 (P = 0,03).
La proportion d'échantillons prénataux séropositifs pour le virus de l'immunodéficience
humaine n'a affiché aucune tendance significative pendant la période à l'étude. La
proportion d'échantillons séropositifs pour la syphilis a augmenté de 2006 à 2008
(0,07 % à 0,21 %; P < 0,0001) et est demeurée relativement stable jusqu'à ce qu'une
diminution s'amorce en 2015. La proportion d'échantillons séronégatifs pour la varicelle
et la rubéole a affiché une importante tendance à la hausse, de l'ordre de 0,48 %
(P < 0,01) et 0,88 % par année (P < 0.01) respectivement.
Conclusions
Le programme albertain de dépistage prénatal des maladies transmissibles sélectionnées
présente un ensemble de données unique qui nous permet d'étudier les résultats de
dépistage à l'échelle provinciale. Les tendances relevées dans les résultats reflètent
celles observées dans la population générale pour les maladies transmissibles et devraient
faire l'objet d'une surveillance afin d'assurer une prise en charge efficace des maladies
infectieuses au sein de la population maternelle et néonatale.
Key Words
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REFERENCES
- Alberta Prenatal Screening Program for Selected Communicable Diseases; Public Health Guidelines [Report].Disease Control and Prevention. Alberta Health and Wellness, Edmonton, AB2007 (Available at:)
- Canadian consensus guidelines for the management of pregnancy, labour and delivery and for postpartum care in HIV-positive pregnant women and their offspring (summary of 2002 guidelines).CMAJ. 2003; 168: 1671-1674
- Canadian Guidelines on Sexually Transmitted Infections: Section 5-10: Canadian Guidelines on Sexually Transmitted Infections- Management and Treatment of Specific Infections – Syphilis.Public Health Agency of Canada, Ottawa2010 (Available at:)
- Canadian Immunization Guide - Vaccination of Specific Populations: Immunization in Pregnancy and Breastfeeding.Public Health Agency of Canada, Ottawa2018 (Available at:)
- The syphilis outbreak in Alberta.Government of Alberta, Edmonton, AB2010 (Available at:)
- ProvLab Laboratory Bulletin. Discontinuation of Second Trimester Syphilis Screening on Pregnant Women.Alberta Health Services, Edmonton, AB2012 (Available at:)https://www.albertahealthservices.ca/assets/wf/lab/wf-lb-prenatal-syphilis-testing.pdfDate accessed: October 30, 2018
- Alberta Reproductive Health: Pregnancy and Births Table Update.Government of Alberta, Edmonton, AB2011 (Available at:)
- Examination of a prenatal syphilis screening program, Alberta, Canada: 2010-2011.Can J Public Health. 2016; 107: E285-E290
- Test uptake and case detection of syphilis, HIV, and hepatitis C among women undergoing prenatal screening in British Columbia, 2007 to 2011.J Obstet Gynaecol Can. 2014; 36: 482-490
- Prenatal HIV Testing in Ontario, January 1, 1999 to December 31, 2012 Ontario.Universoty of Toronto, Toronto, ON2012 (Available at:)http://www.ohemu.utoronto.ca/doc/Prenatal_HIV_Testing_Ontario_2012Q4.pdfDate accessed: May 29, 2017
- National Antenatal Infections Screening Monitoring. Data Tables: England 2006-2015.Public Health England, London2017 (Available at:)
- Appendix 5- hepatitis B: evidence review for newly arriving immigrants and refugees.CMAJ. 2011; 183: E824-E925
- Migration: International, 2010 and 2011.Statistics Canada, Ottawa2015 (Available at:)http://www.statcan.gc.ca/pub/91-209-x/2013001/article/11787-eng.htm#a3Date accessed: August 16, 2011
- Alberta Immigration Progress Report 2011.Government of Alberta, Edmonton, AB2011 (Available at:)
- Report on Hepatitis B and C in Canada: 2014.Public Health Agency of Canada, Ottawa2017 (Available at:)
- Alberta Immunization Program Introductions and Changes.Alberta Health, Edmonton, AB2018 (Available at:)
- Interactive Health Data Application –Age-Sex Specific Incidence Rates for Selected Sexually Transmitted Infections (STI).Alberta Health, Edmonton, AB2017 (Available at:)http://www.ahw.gov.ab.ca/IHDA_Retrieval/redirectToURL.do?cat=81&subCat=466Date accessed: April 11, 2018
- Medical Officer of Health. Re: STI Outbreaks in Alberta.Alberta Health, Edmonton, AB2017 (Available at:)https://www.albertahealthservices.ca/assets/info/hp/phys/if-hp-phys-moh-sti-outbreak.pdfDate accessed: August 1, 2017
- Centre for Communicable Diseases and Infection Control, Infectious Disease Prevention and Control Branch, Public Health Agency of Canada.Public Health Agency of Canada, Ottawa2014 (Available at:)https://www.catie.ca/sites/default/files/64-02-14-1200-STI-Report-2011_EN-FINAL.pdfDate accessed: November 25, 2017
- Infectious and congenital syphilis in Canada, 2010-2015.Can Commun Dis Rep. 2018; 44: 43-48
- Sexually Transmitted Disease Surveillance 2017.U.S. Department of Health and Human Services, Atlanta, GA2018
Public Health England. Sexually Transmitted Infections (STI) Annual Data Tables - Table 2: new STI diagnoses and rates by gender, sexual risk, age group and ethnic group, 2014 to 2018. London: Public Health England; 2019. Available at: https://www.gov.uk/government/statistics/sexually-transmitted-infections-stis-annual-data-tables. Accessed on June 27, 2019.
- Rubella immunity among pregnant women in a Canadian provincial screening program.Can J Infect Dis Med Microbiol. 2009; 20: 73-77
- Determining rubella immunity in pregnant Alberta women 2009–2012.Vaccine. 2015; 33: 635-641
- The economic impact of prenatal varicella immunity among pregnant women in Alberta.Vaccine. 2017; 35: 570-576
- Seroprevalence of rubella antibodies and determinants of susceptibility to rubella in a cohort of pregnant women in Canada, 2008–2011.Vaccine. 2017; 35: 3050-3055
- Dilemmas and pitfalls in rubella laboratory diagnostics in low prevalence or elimination settings.Curr Treat Options Infect Dis. 2016; 8: 329-342
- Rubella Susceptibility Screening in Pregnancy to End in England.Public Health England, London2016 (Available at:)https://www.gov.uk/government/news/rubella-susceptibility-screening-in-pregnancy-to-end-in-englandDate accessed: August 16, 2017
- Serological detection of varicella-zoster virus-specific immunoglobulin G by an enzyme-linked immunosorbent assay using glycoprotein antigen.J Clin Microbiol. 2006; 44: 3094-3097
- Annual Demographic Estimates, Canada, Provinces and Territories.Statistics Canada, Ottawa2010 (Available at:)https://www150.statcan.gc.ca/n1/en/pub/91-215-x/91-215-x2010000-eng.pdf?st=mjmP_wUuDate accessed: October 16, 2018
- Annual Demographic Estimates, Canada, Provinces and Territories.Statistics Canada, Ottawa2014 (Available at:)https://www150.statcan.gc.ca/n1/pub/91-215-x/91-215-x2014000-eng.pdfDate accessed: October 16, 2018
- Rates of rubella immunity among immigrant and non-immigrant women.J Obstet Gynaecol Can. 2009; 31: 409-413
- Rubella seroprevalence in pregnant women in north Thames: estimates based on newborn screening samples.J Med Screen. 2009; 16: 1-6
- Rubella Vaccines: WHO Position Paper. No.29. 86. WHO, Geneva2011: 301-303
Article info
Publication history
Published online: August 22, 2019
Accepted:
May 22,
2019
Received:
February 26,
2019
Footnotes
Competing interests: See Acknowledgements.
Each author has indicated that they meet the journal's requirements for authorship.
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.
