Chlamydia screening for all pregnant women aged between 16 and 25 is cost-effective, finds an Australian study published today (26 August) in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG).
Chlamydia is one of the most common sexually transmitted infections, with prevalence rates ranging from 3% to 14% among young pregnant women (aged 16-25 years) in Australia.
For pregnant women, chlamydia can lead to complications for both mother and baby, including neonatal pneumonia, low birth weight, miscarriage and premature birth. However, as many women experience no symptoms, screening can help to identify and treat the infection before complications develop.
Currently, the US Preventative Services Task Force and the Australian Government recommend chlamydia screening for all pregnant women aged 25 years old and under at their first antenatal visit. In the UK, NICE does not recommend screening as part of routine antenatal care.
This study analysed the cost-effectiveness of chlamydia screening for all pregnant women between 16 and 25, no screening at all, and selective screening for those at higher risk of contracting the infection.
Data showed that implementing a screening program where all pregnant women aged 16 to 25 years received a chlamydia test as part of their routine antenatal care would cost £767 ($1,641) for every additional chlamydia case detected and treated, but could avoid much larger costs of complications of undetected chlamydia, such as managing a low birth weight baby, which may cost over £2800 ($6000), managing neonatal pneumonia which may cost up to £1727 ($3695) and managing pelvic inflammatory disease, which may cost up to £1699 ($3636).
Additionally, results show that when chlamydia prevalence is 3%, screening pregnant women between 16 and 25 is cost-effective and if chlamydia prevalence was higher than 11%, screening could result in cost savings to the Australian healthcare system. The concept of cost-effectiveness means that when taking into account alternative uses for the resources involved, the health outcomes were achieved at an acceptable cost.
Study co-author Dr Jason Ong, from the University of Melbourne, said:
“Our study has shown the cost-effectiveness of routine chlamydia screening for pregnant women aged 16 to 25 years in Australia and will strengthen current guidelines and persuade more healthcare professionals to implement screening locally. We may also be able to generalise our results to other settings with similar healthcare systems costs to Australia.
“The advantage of incorporating chlamydia screening into antenatal care, means that chlamydia can be detected and treated promptly and there are no additional costs of attending another screening programme.”
Patrick Chien, BJOG Deputy Editor-in-chief said:
“This is a large study which uses the most up-to-date evaluation of costs from an Australian perspective. These results are very relevant given the increase in prevalence rates of sexually transmitted infections, including chlamydia over the last decade.”
BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Wiley. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote ‘BJOG’ or ‘BJOG: An International Journal of Obstetrics and Gynaecology’ when referring to the journal and include the website: www.bjog.org as a hidden link online.
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Ong JJ, Chen M, Hocking J, Fairley CK, Carter R. Chlamydia screening for pregnant women aged 16 to 25 years attending an antenatal service: a cost effectiveness study. BJOG 2015: DOI; 10.1111/1471-0528.13567
RCOG response to BJOG study on chlamydia screening
Dr Paul Fogarty, Senior Vice President for the Royal College of Obstetricians and Gynaecologists (RCOG), said:
“The findings of this study may have implications for the UK as we have similar chlamydia rates in under 25s as the Australian population.
“Currently, chlamydia screening is not recommended in the UK as part of routine antenatal care. However, healthcare professionals should provide young pregnant women with information about chlamydia and details of their local National Chlamydia Screening Programme.
“It’s essential that women who are pregnant and think they may be at risk of a sexually transmitted infection speak to their GP or midwife so they can get tested and treated as quickly as possible in order to prevent any possible complications.
“In general, we recommend that sexually active young people are tested for chlamydia every year and on change of a sexual partner. The test is free, widely available, and does not involve an examination.”
For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email email@example.com.
The Royal College of Obstetricians and Gynaecologists is a medical charity that champions the provision of high quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.
- Chlamydia is one of the most common sexually transmitted infections (STIs) in the UK.
- More than 200,000 people test positive for chlamydia each year in England.
- Almost 7 in every 10 people diagnosed with the condition are under 25s.
- More information is available from NHS Choices or Public Health England.