Prenatal Chlamydia Screening Guidelines: Awareness, Adoption, and Acceptability

Background: Chlamydia infections during pregnancy are associated with adverse outcomes such as preterm birth, low birth weight, perinatal death, and miscarriage. Many professional organizations have evidence-based guidelines recommending chlamydia screening during pregnancy, but little is known regarding the factors influencing the adoption of these guidelines into practice. This study assessed the awareness, adoption, and acceptability of prenatal chlamydia screening guidelines among physicians. Methods: Prenatal providers in the United States (MD/DO; n = 201) were recruited via an online survey platform. Items assessed provider awareness about prenatal chlamydia and STI screening guidelines, current practice behaviors, and risk factors considered when screening pregnant patients for STIs. Guideline characteristics including acceptability, feasibility, relative advantage, and evidence source were assessed. Descriptive and bivariate comparisons were analyzed using SAS v9.4. Results: Over 12% of providers were unaware of prenatal STI screening recommendations from their professional organizations, and almost 8% were unaware of chlamydia screening guidelines. Most providers reported using the prenatal chlamydia screening guideline from the American College of Obstetricians and Gynecologists (70%). Those selecting this guideline were significantly more likely to describe this guideline as clear ( P = 0.004) and report that guideline source was important ( P = 0.006) compared to other organization guidelines. Conclusions: Awareness of professional organization guidelines about prenatal chlamydia screening guidelines was high among providers. However, women are not screened adequately during their pregnancies suggesting that there are other factors contributing to the underutilization of screening. Future studies should focus on how these organizations can improve guideline dissemination to increase implementation of chlamydia screening during pregnancy.