Assessment of Screening, Treatment, and Prevention of Perinatal Infections in the Philadelphia Birth Cohort

Jessop, Amy B.; Watson, Barbara; Mazar, Rebecca; Andrel, Jocelyn

doi:10.1177/1062860605279474

Cited by 11 publications

(5 citation statements)

References 27 publications

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“…Providers’ adherence in this study was lower than previous studies [ 8 – 10 ] including one from Indianapolis [ 13 ] (95-98.2%). These studies were published over 15 years ago.…”

Section: Discussioncontrasting

confidence: 85%

“…Studies have also shown that healthcare providers’ adherence to testing guidelines varies significantly from one infectious disease to the other, and that maternal factors such as insurance type and geographical location are factors that contribute to low adherence [ 8 , 9 ]. Several studies have also noted significant differences in providers’ adherence level based on data source [ 8 , 10 – 14 ]. The use of administrative data such as Medicaid data has shown providers’ adherence to prenatal syphilis testing to be 60% [ 13 ] while studies utilizing clinical records have found higher adherence rate over 80% [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have also noted significant differences in providers’ adherence level based on data source [ 8 , 10 – 14 ]. The use of administrative data such as Medicaid data has shown providers’ adherence to prenatal syphilis testing to be 60% [ 13 ] while studies utilizing clinical records have found higher adherence rate over 80% [ 10 , 11 ]. In a previous study we found that among confirmed stillbirth cases, just over 50% received any syphilis test [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

Ojo

Arno

Tao

et al. 2021

BMC Pregnancy Childbirth

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Background The number of congenital syphilis (CS) cases in the United States are increasing. Effective prevention of CS requires routine serologic testing and treatment of infected pregnant women. The Centers for Disease Control and Prevention (CDC) recommends testing all pregnant women at their first prenatal visit and subsequent testing at 28 weeks gestation and delivery for women at increased risk. Methods We conducted a cross-sectional cohort study of syphilis testing among pregnant women with a livebirth delivery from January 2014 to December 2016 in Marion County, Indiana. We extracted and linked maternal and infant data from the vital records in a local health department to electronic health records available in a regional health information exchange. We examined syphilis testing rates and factors associated with non-testing among women with livebirth delivery. We further examined these rates and factors among women who reside in syphilis prevalent areas. Results Among 21260 pregnancies that resulted in livebirths, syphilis testing in any trimester, including delivery, increased from 71.7% in 2014 to 86.6% in 2016. The number of maternal syphilis tests administered only at delivery decreased from 16.6% in 2014 to 4.04% in 2016. Among women living in areas with high syphilis rates, syphilis screening rates increased from 79.6% in 2014 to 94.2% in 2016. Conclusion Improvement in prenatal syphilis screening is apparent and encouraging, yet roughly 1-in-10 women do not receive syphilis screening during pregnancy. Adherence to recommendations set out by CDC improved over time. Given increasing congenital syphilis cases, the need for timely diagnoses and prevention of transmission from mother to fetus remains a priority for public health.

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“…Providers’ adherence in this study was lower than previous studies [ 8 – 10 ] including one from Indianapolis [ 13 ] (95-98.2%). These studies were published over 15 years ago.…”

Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

Ojo

Arno

Tao

et al. 2021

BMC Pregnancy Childbirth

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show abstract

“…This finding clearly implies that prenatal testing is a successful screening tool for identifying women with chronic hepatitis B. Other studies, including a nationwide survey of hospitals, have had similar results with prenatal HBsAg test results documented in 92.6% of maternal medical records . It is reassuring to see that universal prenatal HBV testing, which was recommended by USPSTF in 2004, after risk‐based testing was not capturing all women, has become the norm and is now successfully implemented .…”

Section: Discussionmentioning

confidence: 54%

Discontinuity of care for mothers with chronic hepatitis B diagnosed during pregnancy

Rajbhandari

Barton

Juncadella

et al. 2016

Journal of Viral Hepatitis

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Assiduous measures are taken to prevent perinatal transmission of hepatitis B virus (HBV) to infants; it is unclear whether the mothers receive appropriate care for their chronic HBV. We sought to assess the quality of HBV care in hepatitis B surface antigen (HBsAg)-positive mothers following pregnancy. HBsAg-positive women (n = 243) who had sought prenatal care at Massachusetts General Hospital were retrospectively identified and charts reviewed. The primary outcome was adherence to the American Association for the Study of Liver Diseases (AASLD) and American College of Obstetricians and Gynecologists guidelines. Over one-third (37%) of women were first diagnosed with HBV infection at a prenatal visit. One-third (32%) did not undergo timely liver function test measurements. HBV DNA was never measured in 26% and was untimely in 34% of patients. One-third (34%) of the women were at high-risk for HCC based on AASLD criteria, yet only 33% of these women underwent timely imaging. Nearly half (49%) never saw a liver specialist for their HBV care. In multivariate analysis, women were 3.7 times more likely to have a timely ALT and 8.1 times more likely to have a timely HBV DNA if they were followed by a liver specialist (P = 0.001, <0.001). We demonstrate remarkably inadequate and discontinuous HBV care for chronically infected mothers following pregnancy. As HBV infection is already being identified prenatally, quality improvement measures encompassing obstetricians, primary care providers and hepatologists are needed to ensure that HBV-infected women are linked to care postpregnancy.

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“…This study relied on maternal self-report; our study has as a strength our ability to have objective evidence of GBS status availability. Another investigation of predictors of screening for perinatal infections in 2000–2001 revealed no differences by race/ethnicity or insurance status with regards to universally-recommended screenings for infections such as hepatitis B, syphilis and rubella, but did show some variation by both race/ethnicity and insurance for infections in which recommendations at the time were based on risk factors, such as GBS, hepatitis C and varicella [15]. The authors suggest that the systems of care in which minority and poor women may be enrolled may have different practice standards, reflective of provider and patient awareness, as well as reimbursement rates of insurers.…”

Section: Commentmentioning

confidence: 99%

Equality in Obstetrical Care: Racial/Ethnic Variation in Group B Streptococcus Screening

Bryant

Cheng

Caughey

2010

Matern Child Health J

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The objective of this article is to determine whether racial/ethnic disparities exist in screening for group B streptococcus (GBS) colonization among pregnant women. A retrospective cohort study of deliveries at a single institution was conducted. The primary outcome was the availability of GBS culture data at the time of delivery; the primary predictor was maternal race/ethnicity. Analyses were stratified by the time periods before and after the CDC recommendations for universal screening for GBS. Among 16,333 deliveries, 60.4% of the population was screened for GBS but screening rates varied markedly by year of delivery. Black women had a lower odds of having available GBS data (AOR 0.81 [0.69, 0.95]) but this disparity was limited to the period of time before universal screening was recommended. Prior to the recommendation for universal screening for GBS, racial/ethnic disparities existed in rates of screening among pregnant women delivering at term. These differences were reduced after 2002, suggesting that uniform policies regarding obstetrical care may be effective in eliminating disparities in obstetrical care and outcomes.

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Assessment of Screening, Treatment, and Prevention of Perinatal Infections in the Philadelphia Birth Cohort

Cited by 11 publications

References 27 publications

Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

Syphilis testing adherence among women with livebirth deliveries: Indianapolis 2014-2016

Discontinuity of care for mothers with chronic hepatitis B diagnosed during pregnancy

Equality in Obstetrical Care: Racial/Ethnic Variation in Group B Streptococcus Screening

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