Initial and repeat testing for chlamydia during pregnancy.

OBJECTIVE

This study was done to evaluate the prevalence of chlamydia in late pregnancy after an initial negative test.

METHODS

This retrospective cohort study reports prenatal patients entering care between January 1998 and May 2000 at an inner city community based clinic (n = 752). Patients were evaluated if results of initial and late tests (34 weeks gestational age) for chlamydia were known. Charts were abstracted for demographic and pregnancy-related factors. Analysis for categorized data was by chi-squares and odds ratios. Continuous data were analyzed by t-test. Significance was accepted if p < 0.05.

RESULTS

The prevalence of chlamydia was 17.8%, with 3.9% having only the second test positive. Treatment failure and/or reinfection were found in 13.3%. Factors correlated with chlamydial carriage include: age 19 years (p < 0.001), gonorrheal carriage (p < 0.001), lower gravidity (p < 0.01), lower parity (p < 0.05), and never having married (p < 0.001). Logistic regression identified gonorrheal carriage and age 19 years as important for both initial and late chlamydial cervicitis. Marital status was important for initial tests only.

CONCLUSIONS

In our high-risk population, repeat testing for chlamydia in late pregnancy was found appropriate.