Kwan Kellie S H, Giele Carolien M, Combs Barry, Mak Donna B
Department of Health, Western Australia, Perth Business Centre, WA 6849, Australia.
Sex Health. 2012 Sep;9(4):349-54. doi: 10.1071/SH11151.
Antenatal testing for specified sexually transmissible infections (STIs) and blood-borne viruses (BBVs) is recommended by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG). In 2007, the Department of Health, Western Australia (DoHWA) issued an operational directive (OD) recommending universal testing for chlamydia and additional testing for women in the STI endemic regions of Western Australia (WA). To assess adherence to these guidelines, seven WA public hospitals were audited.
Demographic details and testing information of the last 200 women who gave birth immediately before 30 June 2007 (baseline audit) and 30 June 2010 (follow-up audit) were obtained from each hospital's antenatal records.
Data from 2718 women who delivered at ≥36 weeks' gestation were analysed (baselinen=1353; follow-upn=1365). Testing at the first antenatal visit in accordance with the guidelines improved over time (RANZCOG: 68-74%; χ(2)-test = 13.96, d.f.=1, P<0.001; DoHWA OD: 12-40%; χ(2)-test = 279.71, d.f.=1, P<0.001). Retesting at 28-36 weeks' gestation in the STI endemic regions improved for chlamydia (3-10%; χ(2)-test = 17.40, d.f.=1, P<0.001) and gonorrhoea (3-7%; χ(2)-test=6.62, d.f.=1, P<0.05), but not for syphilis or HIV. Chlamydia prevalence was 3% and 8% among nonAboriginal and Aboriginal women, respectively.
The proportion of women delivering in WA public hospitals who had antenatal STI and BBV tests improved after publication and promotion of the OD.
澳大利亚和新西兰皇家妇产科医师学院（RANZCOG）建议对特定性传播感染（STIs）和血源病毒（BBVs）进行产前检测。2007年，西澳大利亚卫生部（DoHWA）发布了一项操作指令（OD），建议对衣原体进行普遍检测，并对西澳大利亚（WA）性传播感染流行地区的女性进行额外检测。为评估对这些指南的遵守情况，对西澳大利亚的七家公立医院进行了审计。
从每家医院的产前记录中获取了2007年6月30日之前（基线审计）和2010年6月30日之前（随访审计）最后200名分娩女性的人口统计学细节和检测信息。
分析了2718名孕周≥36周分娩女性的数据（基线n = 1353；随访n = 1365）。随着时间的推移，按照指南在首次产前检查时进行检测的情况有所改善（RANZCOG：68 - 74%；χ²检验 = 13.96，自由度 = l，P < 0.001；DoHWA OD：12 - 40%；χ²检验 = 279.71，自由度 = l，P < 0.001）。在性传播感染流行地区，孕28 - 36周时衣原体（3 - 10%；χ²检验 = 17.40，自由度 = l，P < 0.001）和淋病（3 - 7%；χ²检验 = 6.62，自由度 = l，P < 0.05）的重新检测情况有所改善，但梅毒或艾滋病毒检测无改善。非原住民和原住民女性的衣原体患病率分别为3%和8%。
在发布并推广该操作指令后，在西澳大利亚公立医院分娩的女性进行产前性传播感染和血源病毒检测的比例有所提高。
