Urine screening for Chlamydia trachomatis during pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Chlamydia trachomatis (CT) is a common sexually transmitted infection.
• Screening for CT is crucial in pregnant populations to prevent adverse outcomes.
• Cervical sampling is the traditional method for CT detection in pregnant women.

Purpose of the Study:

• To compare the diagnostic accuracy of urine versus endocervical samples for CT detection in pregnant women.
• To evaluate the utility of urine-based CT screening in late-term pregnancy.

Main Methods:

• A cross-sectional study involving 2,018 pregnant women at 35-37 weeks gestation.
• Both urine and endocervical samples were collected from each participant.
• The Aptima Combo 2 Assay was used for CT detection in both sample types.

Main Results:

• The prevalence of CT was 4.3% in endocervical samples and 4.1% in urine samples.
• McNemar's test showed no statistically significant difference between the two sampling methods (P=.083).
• The κ statistic indicated excellent agreement between urine and cervical sample results (0.982).

Conclusions:

• Urine sampling demonstrates equivalent performance to endocervical sampling for CT detection in pregnant women.
• The Aptima Combo 2 Assay is reliable for CT screening using urine samples during pregnancy.
• Urine testing offers a non-invasive and effective alternative for CT screening in obstetric care.