Socio-economic aspects of extended STD screening in pregnancy

Screening for sexually transmitted diseases (STDs) in early pregnancy is included in routine antenatal care for several infectious agents in many western European countries. Pharmaco-economics of these interventions have been evaluated. Currently, reconsideration of antenatal screening is ongoing, with explicit attention given to extending the STD testing to some other infectious agents, such as HIV and Chlamydia trachomatis (CT). This paper examines the socio-economics of such extensions for the Netherlands and the UK. Based on pharmaco-economic investigations in the UK and the Netherlands, we argue that serious consideration should be given to expanding antenatal STD screening to include universal testing for HIV and CT. Further research should be directed to the economic aspects of paediatric HIV infection and the epidemiology of CT in pregnancy.