Screening for infectious diseases in pregnant, foreign-born women from multiple global areas

To describe and compare infectious diseases commonly screened for during pregnancy among pregnant immigrant women from multiple global regions.

We retrospectively reviewed the charts of all women born outside the United States who delivered at Vanderbilt University Medical Center during 2003-2006. These women were identified through the birth certificate applications for their children. The primary outcomes were prevalence of positive tests for tuberculosis, HIV, hepatitis B, gonorrhea and Chlamydia, rubella immunity and syphilis.

During the years 2003-2006, 1,767 immigrant women gave birth at Vanderbilt University Medical Center. The women were from Africa (17%), Asia (25%), Europe (11%), Latin America (26%), Middle East (18%), North America (2%) and Oceana (1%). There were no statistically significant differences in prevalence among immigrant groups for positive purified protein derivatives (PPDs), rubella titers, rapid plasma reagin (syphilis) and gonorrhea. Significantly more women from Asia and Africa had positive hepatitis B surface antigen. Asian women were less likely than other immigrant groups to be positive for HIV. Significant differences were also noted among groups for Chlamydia. Screening rates differed by immigrant groups and were related to mode of testing.

Our data reinforce the importance of screening for diseases for which vaccinations are available, especially for hepatitis B and rubella. The data also show the importance of following up positive PPDs, particularly among pregnant immigrant women. Screening differences among groups may exist, and further research is needed to examine causal factors.