Pregnant Women Undertested for STIs, Finds Quest Diagnostics Health Trends® Study of Over 4 Million Pregnancies
A Quest Diagnostics study published in the Journal of Lower Genital Tract Disease reveals significant gaps in STI testing for pregnant women. Analyzing over 4 million pregnancies, researchers found that 4% of women tested positive for chlamydia or gonorrhea in the first trimester. Alarmingly, 35% of these women didn't receive a follow-up negative test before delivery, suggesting potential untreated infections. The study highlights inconsistencies in guideline-based care, with 2% of initially negative patients later testing positive during pregnancy. Researchers recommend improving adherence to existing guidelines and updating recommendations for STI testing to enhance maternal and newborn health outcomes.
Uno studio di Quest Diagnostics pubblicato nel Journal of Lower Genital Tract Disease rivela significative lacune nei test per le IST per le donne in gravidanza. Analizzando oltre 4 milioni di gravidanze, i ricercatori hanno scoperto che il 4% delle donne ha testato positivo per clamidia o gonorrea nel primo trimestre. Allarmante, il 35% di queste donne non ha ricevuto un test di follow-up negativo prima del parto, suggerendo potenziali infezioni non trattate. Lo studio evidenzia le incoerenze nella cura basata sulle linee guida, con il 2% delle pazienti inizialmente negative che in seguito hanno testato positive durante la gravidanza. I ricercatori raccomandano di migliorare l'adesione alle linee guida esistenti e di aggiornare le raccomandazioni per i test di IST per migliorare i risultati di salute materna e neonatale.
Un estudio de Quest Diagnostics publicado en el Journal of Lower Genital Tract Disease revela importantes lagunas en las pruebas de ITS para mujeres embarazadas. Al analizar más de 4 millones de embarazos, los investigadores encontraron que el 4% de las mujeres dio positivo por clamidia o gonorrea en el primer trimestre. Alarmantemente, el 35% de estas mujeres no recibió una prueba negativa de seguimiento antes del parto, lo que sugiere posibles infecciones no tratadas. El estudio destaca las inconsistencias en la atención basada en guías, con un 2% de las pacientes inicialmente negativas que luego dieron positivo durante el embarazo. Los investigadores recomiendan mejorar la adherencia a las guías existentes y actualizar las recomendaciones para las pruebas de ITS para mejorar los resultados de salud materna y neonatal.
Quest Diagnostics의 연구가 Journal of Lower Genital Tract Disease에 발표되었으며, 임산부를 위한 성병 테스트의 중요한 격차를 드러냈습니다. 400만 건 이상의 임신을 분석한 결과, 4%의 여성들이 첫 번째 삼 분기에 클라미디아 또는 임질에 양성 반응을 보였습니다. 놀랍게도, 35%의 여성들은 출산 전 부정적인 추적 검사를 받지 않아 감염이 치료되지 않았을 가능성이 있음을 시사합니다. 이 연구는 가이드라인 기반 치료의 일관성이 부족함을 강조하며, 2%의 초기 음성 환자가 임신 중 나중에 양성 반응을 보였습니다. 연구자들은 기존 지침의 준수를 개선하고 성병 검사에 대한 권장 사항을 업데이트하여 모성과 신생아 건강 결과를 향상시킬 것을 권장합니다.
Une étude menée par Quest Diagnostics et publiée dans le Journal of Lower Genital Tract Disease révèle des lacunes importantes dans le dépistage des IST chez les femmes enceintes. En analysant plus de 4 millions de grossesses, les chercheurs ont découvert que 4% des femmes avaient testé positif pour la chlamydia ou la gonorrhée au premier trimestre. Alarmant, 35% de ces femmes n'ont pas reçu de test négatif de suivi avant l'accouchement, suggérant des infections potentiellement non traitées. L'étude met en évidence des incohérences dans les soins basés sur les recommandations, avec 2% des patientes initialement négatives qui ont ensuite testé positif pendant leur grossesse. Les chercheurs recommandent d'améliorer l'adhésion aux directives existantes et de mettre à jour les recommandations pour le dépistage des IST afin d'améliorer les résultats de santé maternelle et néonatale.
Eine Studie von Quest Diagnostics, veröffentlicht im Journal of Lower Genital Tract Disease, zeigt signifikante Lücken bei den STI-Tests für schwangere Frauen. Die Analyse von über 4 Millionen Schwangerschaften ergab, dass 4% der Frauen im ersten Trimester positiv auf Chlamydien oder Gonorrhö getestet wurden. Alarmierend ist, dass 35% dieser Frauen vor der Entbindung keinen folge-negativen Test erhielten, was auf potenziell unbehandelte Infektionen hinweist. Die Studie hebt Inkonsistenzen in der richtlinienbasierten Versorgung hervor, wobei 2% der anfänglich negativen Patientinnen später während der Schwangerschaft positiv getestet wurden. Die Forscher empfehlen, die Einhaltung der bestehenden Richtlinien zu verbessern und die Empfehlungen für STI-Tests zu aktualisieren, um die Gesundheitsresultate für Mütter und Neugeborene zu verbessern.
- Large-scale study covering 4,077,212 pregnancies across all 50 states and D.C.
- Identification of gaps in STI testing and treatment during pregnancy, potentially leading to improved guidelines
- Quest Diagnostics (DGX) positioning itself as a leader in women's health research and diagnostics
- Over 4% of pregnant women tested positive for chlamydia or gonorrhea in the first trimester
- 35.1% of chlamydia-positive and 36.9% of gonorrhea-positive women did not receive a follow-up negative test before delivery
- About 2% of initially negative patients later tested positive during pregnancy, indicating ongoing infection risk
Insights
This study reveals significant gaps in STI testing and treatment during pregnancy, highlighting a critical public health issue. Over 4% of pregnant women tested positive for chlamydia or gonorrhea in the first trimester, with
The inconsistency in guidelines across agencies and the outdated age-based screening recommendations are particularly concerning. The study's large scale (4,077,212 pregnancies) and national representation lend credibility to its findings, making a strong case for updating and harmonizing STI testing protocols in prenatal care.
This study underscores the urgent need for policy reform in maternal healthcare. The lack of adherence to existing guidelines and the inconsistencies between different agencies' recommendations create a fragmented approach to STI testing during pregnancy. Policymakers should consider:
- Harmonizing guidelines across agencies to ensure consistent care
- Updating age-based screening recommendations to reflect current demographic trends
- Implementing systems to ensure follow-up testing and treatment
- Increasing education for healthcare providers on the importance of guideline adherence
These changes could significantly improve maternal and newborn health outcomes, potentially reducing the 2.5 million annual STI cases reported by the CDC.
For Quest Diagnostics (NYSE: DGX), this study could have mixed financial implications. On one hand, it highlights the company's role in important medical research, potentially enhancing its reputation and market position in the diagnostics sector. The study's findings could lead to increased demand for STI testing services, benefiting Quest's revenue streams.
However, the revelation of suboptimal testing practices might also prompt scrutiny of laboratory testing protocols and potentially lead to regulatory changes. While this could create short-term challenges, it also presents opportunities for Quest to lead in developing improved testing guidelines and protocols, potentially securing a larger market share in the long run.
One in three women who tested positive for chlamydia or gonorrhea while pregnant were not retested before giving birth, despite potential to transmit infections to newborns
The study, titled Chlamydia and gonorrhea testing in pregnancy: Time to improve adherence and update recommendations, was published in the peer reviewed Journal of Lower Genital Tract Disease, the official journal of the American Society for Colposcopy and Cervical Pathology. It is based on deidentified results of lab tests performed by Quest in all 50 states and the
The findings suggest gaps in guideline-based care, intended to reduce the risk of infection and medical complications. Untreated chlamydia and gonorrhea can raise risks of infertility and pelvic inflammatory disease in women. The risk of transmission during birth is approximately
"Our study adds to a troubling body of evidence highlighting inconsistent quality in maternal and child healthcare in the
Key findings:
- Over
4% of women who received guideline-based screening for chlamydia or gonorrhea in pregnancy during the first trimester received a positive result for one or both infections. - More than one in three of these women (
35.1% chlamydia;36.9% gonorrhea) did not receive a follow up negative test before delivery, suggesting they may not have been treated and cured (or were treated, cured but then reinfected) before birth. - About
2% of patients who received a negative test result for chlamydia or gonorrhea early in pregnancy later received a positive result, suggesting "an ongoing risk of infection during pregnancy". Of these, about one in two were still positive prior to delivery. (53.0% chlamydia and49.3% gonorrhea).
The authors believe reinfections (or ineffectively treated initial infections) may result in an increased number of deliveries while women are positive with one or more STIs, which can impact both maternal and newborn health.
The authors conclude current guidelines are inconsistent and they provide several recommendations for improvements. For instance, the CDC recommends women be retested for cure at 4 weeks of pregnancy while the USPSTF recommends retesting before 3 weeks. Current guidelines also do not recommend screening women after the age of 25 years unless there are risk factors (such as multiple partners), based on a study from 1998 when women married at younger ages than today. Guidelines recommend that all women under the age of 25 be screened, regardless of perceived risk.
The study's strengths include its large size, national representation, and use of objective laboratory data. Its limitation is the lack of clinical follow-up information for the positive cases, as testing was limited to one national clinical laboratory. While the authors did not evaluate other STIs, such as syphilis, they caution these patterns of irregular adherence to guideline-based testing in maternal care may extend to other conditions.
According to the Centers for Disease Control and Prevention (CDC), cases of sexually transmitted disease are at an all-time high, with more than 2.5 million cases of syphilis, gonorrhea, and chlamydia reported in
About Quest Diagnostics
Quest Diagnostics works across the healthcare ecosystem to create a healthier world, one life at a time. We provide diagnostic insights from the results of our laboratory testing to empower people, physicians and organizations to take action to improve health outcomes. Derived from one of the world's largest databases of de-identifiable clinical lab results, Quest's diagnostic insights reveal new avenues to identify and treat disease, inspire healthy behaviors and improve healthcare management. Quest Diagnostics annually serves one in three adult Americans and half the physicians and hospitals in
For more Quest Diagnostics Health Trends® reports, visit www.Newsroom.QuestDiagnostics.com/Health-Trends.
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SOURCE Quest Diagnostics
FAQ
What percentage of pregnant women tested positive for STIs in the Quest Diagnostics study?
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