Vainder Marina, Kives Sari, Yudin Mark H
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON.
Department of Obstetrics and Gynaecology, St. Michael's Hospital, University of Toronto, Toronto, ON.
J Obstet Gynaecol Can. 2019 Sep;41(9):1289-1294. doi: 10.1016/j.jogc.2019.02.006. Epub 2019 Apr 3.
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.
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.
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).
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.
本研究旨在确定作为产前护理一部分接受淋病和衣原体检测的孕妇比例，并探讨影响检测率的患者和提供者因素。
研究人员对2015年11月至2016年4月期间在安大略省多伦多市一家城市三级护理中心圣迈克尔医院分娩的所有患者进行了回顾性病历审查。计算了淋病和衣原体的检测率及检测阳性结果的患病率。采用卡方检验比较不同类型产前护理提供者（产科医生、母胎医学专家、家庭医生、助产士）之间的检测率，并确定检测率是否受患者人口统计学特征或特性的影响。本研究为加拿大工作组分类II-2回顾性队列研究。
在研究期间于圣迈克尔医院分娩的1315名妇女中，1220名符合研究纳入标准。在这些妇女中，186名（15.3%）在孕期未接受淋病和衣原体检测。有11例衣原体感染（1.1%），无淋病病例。检测率不受患者人口统计学变量或产科病史的影响。助产士和家庭医生在提供者组中的检测率最高，分别为93.8%和91.4%。普通产科医生对其88.5%的患者进行了检测。母胎医学专家的检测率明显低于其他提供者组，为64.8%（P<0.0001）。
尽管作为常规产前护理的一部分建议进行检测，但在研究期间仍有15%的妇女未接受淋病和衣原体检测。不同提供者的检测率有所不同，需要探索提高这些检测率的策略。
