Adherence to Sexually Transmitted Infection Screening in Pregnancy

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Public Health

Background:

• Professional guidelines and state laws mandate sexually transmitted infection (STI) screening during pregnancy.
• Adherence to recommended STI screening protocols ensures maternal and fetal health.
• Previous studies suggest potential disparities in healthcare access and adherence to screening recommendations.

Purpose of the Study:

• To evaluate adherence to recommended sexually transmitted infection (STI) screening guidelines during pregnancy.
• To identify demographic and insurance-related factors associated with adherence to initial and repeat STI screening.
• To assess the performance of syphilis, HIV, hepatitis B, chlamydia, and gonorrhea screening in a prenatal care setting.

Main Methods:

• Retrospective cohort study of 2370 patients initiating prenatal care before 20 weeks' gestation.
• Abstracted demographic data and STI screening test results (initial and third trimester) from prenatal records.
• Used multivariable logistic regression to analyze factors associated with adherent screening.

Main Results:

• Only 76.6% of patients received adherent initial STI screening.
• Adherence to third trimester screening for syphilis and HIV was significantly lower at 7.8%.
• Private insurance was linked to higher initial screening adherence but lower repeat screening adherence; non-Hispanic Black and Hispanic patients had lower initial screening adherence, while non-Hispanic Black patients had higher repeat screening adherence.

Conclusions:

• Sexually transmitted infection (STI) screening rates during pregnancy remain suboptimal.
• Significant racial/ethnic and insurance-related disparities exist in both initial and repeat STI screening adherence.
• Efforts are needed to improve screening adherence and address disparities to ensure comprehensive prenatal care.