Suboptimal prenatal screening of and infections in a Montréal birthing and tertiary care centre: A retrospective cohort study.

BACKGROUND

The Canadian Paediatric Society no longer recommends the use of universal ocular prophylaxis with erythromycin ointment to prevent ophthalmia neonatorum. Screening for and in all pregnant women is considered the most effective way of preventing vertical transmission and ophthalmia neonatorum.

OBJECTIVE

The aims of this study were to assess prenatal screening rates of and and to compare sociodemographic factors between those screened and those not screened.

METHODS

The list of all women who delivered at a tertiary care hospital in Montréal, Québec, between April 2015 and March 2016, was cross-referenced with the list of samples tested for and . Maternal medical records were reviewed for demographic, prenatal and diagnostic information.

RESULTS

Of 2,688 mothers, 2,245 women were screened at least once, but only 2,206 women had at least one valid and result the day of delivery (82.1%; 95% CI: 80.6%-83.5%). Infection was detected in 46/2,206 (2.1%) screened women: 42 had infection, two had infection and two were co-infected. infection was more frequent in women younger than 25 years (9.8%; 95% CI: 6.7%-13.8%) than in older women (0.8%; 95% CI: 0.4%-1.3%; <0.001). Each increase in parity decreased the probability of being tested (adjusted odds ratio=0.89; 95% CI: 0.80%-0.97%; =0.01). Of those with an initial negative test result, 35/267 (13.1%; 95% CI: 9.3%-17.8%) of women younger than 25 years and 122/1,863 (6.6%; 95% CI: 5.5%-7.8%; <0.001) of women aged 25 years and older were retested. Subsequent infection was detected in 4/35 (11%) women, all younger than 25.

CONCLUSION

Suboptimal screening rates for and suggest that current universal ocular prophylaxis cannot be discontinued. Repeating universal screening should be considered, especially among those younger than 25 years.