Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC 27599, USA.
Sex Transm Dis. 2011 Mar;38(3):172-4. doi: 10.1097/OLQ.0b013e3181f41b96.
Negative maternal and fetal consequences associated with Chlamydia trachomatis and Neisseria gonorrhoeae during pregnancy make diagnosis essential. The Centers for Disease Control and Prevention recommend routine screening for sexually transmitted infections at the first prenatal visit, and third trimester repeat screening, specifically for C. trachomatis, is recommended for women under age 25 or at increased infection risk. The effect of repeat screening on diagnosis during pregnancy is not well documented among adolescents.
A prospective cohort of 125 pregnant adolescents with at least one prenatal screening for C. trachomatis and N. gonorrhoeae was analyzed. All participants received prenatal care and delivered at one urban teaching hospital in Washington, DC. Screening results were documented for both sexually transmitted infections. Descriptive and univariate analyses were performed to describe disease prevalence.
Of pregnant adolescents, 31% were diagnosed with either C. trachomatis or N. gonorrhoeae infection during pregnancy. Of the 75% (95/125) of patients who had more than one screening test, 11% (10/95) had a reinfection, and 7% (7/95) had a new infection on repeat testing. Nine percent (9/95) had recurrent C. trachomatis, whereas 4% (4/95) had a new diagnosis. Three percent (3/95) had recurrent N. gonorrhoeae, whereas 4% (4/95) had a new diagnosis. Some experienced coinfection at either initial or repeat testing.
Screening for C. trachomatis and N. gonorrhoeae is recommended during pregnancy. In this sample of pregnant adolescents, the overall high incidence and recurrence of C. trachomatis and N. gonorrhoeae support Centers for Disease Control and Prevention screening and rescreening recommendations, regardless of initial test results.
与沙眼衣原体和淋病奈瑟菌相关的母婴不良后果使妊娠期诊断变得至关重要。美国疾病控制与预防中心建议在首次产前就诊时对性传播感染进行常规筛查，对于年龄在 25 岁以下或感染风险增加的女性，建议在妊娠晚期再次筛查沙眼衣原体。在青少年中，重复筛查对妊娠期间诊断的影响尚未得到充分记录。
对 125 名至少接受过一次沙眼衣原体和淋病奈瑟菌产前筛查的妊娠青少年进行了前瞻性队列研究。所有参与者均在华盛顿特区的一家城市教学医院接受产前护理和分娩。对两种性传播感染的筛查结果进行了记录。进行了描述性和单变量分析，以描述疾病流行率。
在妊娠青少年中，31%被诊断患有沙眼衣原体或淋病奈瑟菌感染。在 75%（95/125）的患者中，有超过一次筛查测试，11%（10/95）发生了再感染，7%（7/95）在重复测试时发生了新感染。9%（9/95）有复发性沙眼衣原体，而 4%（4/95）有新的诊断。3%（3/95）有复发性淋病奈瑟菌，而 4%（4/95）有新的诊断。一些人在初次或重复检测时发生了合并感染。
推荐在妊娠期间筛查沙眼衣原体和淋病奈瑟菌。在本妊娠青少年样本中，沙眼衣原体和淋病奈瑟菌的高发生率和高复发率支持美国疾病控制与预防中心的筛查和再筛查建议，无论初始检测结果如何。
