The following is a summary of “Developing sentinel surveillance for chlamydia, gonorrhea, and trichomonas using test results from routine screening during pregnancy,” published in the FEBRUARY 2023 issue of Obstetrics and Gynecology by Lazenby G, et al.

For a study, researchers sought to develop an electronic health record (EHR)-based approach for sexually transmitted infection (STI) surveillance in a sentinel population of pregnant persons that is sustainable.

Researchers conducted a one-year surveillance study of STIs in people who had at least one visit related to pregnancy. An analytical EHR code was used to collect the data. According to whether or not they had a chlamydia test while pregnant and the results of the STI test, positive or negative, subjects were divided into groups. To find differences between those who were examined for STIs and those who weren’t, as well as between those who tested positive and those who tested negative, bivariate analyses were conducted. Logistic regression analysis was used to identify the predictors of a positive STI test.

A total of 4,553 pregnant persons received pregnancy care from 1/1/2021 to 12/31/2021. 76% (n=3,454) of persons had a chlamydia test during pregnancy. Persons identifying as white or with private insurance were less likely to have a test. Among persons screened, the most commonly detected STI was Trichomonas (5%), followed by chlamydia (4%) and gonorrhea (0.7%). Predictors of positive STI tests were self-reported Black race [Trichomonas, aOR 5.3 (95% CI 3.2-8.9) and gonorrhea, aOR 5.3 (95% CI 3.2-8.9)] and age < 25 [chlamydia, aOR 3.7 (95% CI 2.5-5.6)].

The percentage of positive STI tests among pregnant women during the surveillance period was consistent with previous observations in this population. The study demonstrated the utility of an EHR for STI surveillance and suggested that this model could be used more broadly to improve national STI surveillance data accuracy.

Reference: https://www.ajog.org/article/S0002-9378(22)01011-0/fulltext