Preventing vertical transmission: Are pregnant women getting the tests they need?

Transmission of disease from mother to child during pregnancy, and during labor and delivery, can lead to severe health complications for a newborn baby. Healthcare providers play a critical role in preventing vertical transmission of severe diseases by testing for select conditions. The Centers for Disease Control and Prevention recommends that pregnant women get tested for human immunodeficiency virus (HIV), group B streptococcus (GBS), hepatitis B surface antigen (HBsAg), rubella, syphilis, and Chlamydia, as part of prenatal care, and during labor and delivery. The goal of this study was to determine the proportion of pregnant women who were tested for these infectious diseases during pregnancy and again during labor and delivery. Data were abstracted from the medical records of 220 women who delivered a baby at a hospital in Detroit, MI between April 1, 2006 and March 30, 2007. Study results indicated that each test was carried out on approximately half (range: 48-62%) of women during prenatal care. During labor and delivery, 96% of the women were tested for syphilis, but fewer than 12% (range: 4-12%) were tested for each of the other diseases. Data regarding associations between testing patterns and Medicaid status and between testing patterns and prenatal care will also be presented. Barriers to infectious disease testing as a step in preventing vertical transmission of specific diseases and potential facilitators to increasing the proportion of women who are tested for these diseases will be discussed.