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High Prevalence of Chlamydia and Pap‐smear Abnormalities in Pregnant Adolescents Warrants Routine Screening
Author(s) -
Quinlivan Julie A.,
Petersen Rodney W.,
Gurrin Lyle C.
Publication year - 1998
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1998.tb03060.x
Subject(s) - medicine , cohort , chlamydial infection , chlamydia , incidence (geometry) , obstetrics , gynecology , cohort study , prospective cohort study , pediatrics , chlamydia trachomatis , immunology , physics , optics
Summary: A prospective cohort of pregnant adolescent patients who planned to deliver at 1 of 3 Perth metropolitan hospitals was studied; 1 subgroup of this cohort was offered universal screening for cervical chlamydial infection and Pap‐smear abnormalities (screened), and the remainder of the cohort were offered screening at the discretion of the attending medical staff (control). High prevalences of both chlamydial infection (27%) and Pap‐smear abnormalities (38%) were detected in the screened cohort. The majority of Pap‐smear abnormalities were inflammatory atypia, but high‐grade Bethesda lesions were also diagnosed. In the control group, the prevalence of positive swabs and abnormal Pap‐smear reports in those tested was also high (22% and 35% respectively), but significantly fewer patients were tested (18% and 33% respectively in the control group, compared to 92% and 94% in the screened group; both p < 0.001). Screening and treatment of chlamydia was associated with a significant decrease in the incidence of newborn febrile morbidity (10% versus 25%; p = 0.02). In view of the high prevalence of positive results, it is cost‐effective to offer universal screening in this setting. Failure to introduce a specific screening policy can result in a significant number of patients being denied the advantages of diagnosis and treatment.