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Accuracy of tests used to detect infection with Chlamydia trachomatis in asymptomatic pregnant women: a systematic review

Sahi, Siew-Veenaa; Rogozińska, Ewelinaa,b; Sobhy, Sohaa; Khan, Khalid S.a,b

Current Opinion in Obstetrics and Gynecology: December 2017 - Volume 29 - Issue 6 - p 375–382
doi: 10.1097/GCO.0000000000000411
WOMEN'S HEALTH: Edited by Joseph Aquilina
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Purpose of review Infection with Chlamydia trachomatis in pregnancy is linked to increased risk of miscarriage, stillbirth, and preterm birth. Currently, PCR or DNA-based tests are the gold standard when detecting the infection; however, they are costly and require access to specialist equipment. The aim of this systematic review was to assess the accuracy of available tests to detect infection in an asymptomatic pregnant population.

Recent findings There was evidence of the superior accuracy of nucleic acid amplification tests to cell culture in nonpregnant asymptomatic women; however, there are multiple commercial nucleic acid amplification tests with varying sensitivities and specificities. There is a gap in current literature on accuracy studies in an asymptomatic pregnant population, particularly within routine antenatal settings.

Summary There is a need for a point-of-care test for Chlamydia in pregnancy. Future test accuracy studies for this population should aim to use a universally established reference standard. Further research should provide relevant evidence to guide practice.

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aWomen's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom

bMultidisciplinary Evidence Synthesis Hub (mEsh), Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom

Correspondence to Siew-Veena Sahi, Women's Health Research Unit, Centre for Primary Care and Public Health, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 58, Turner Street, London E1 2AB, UK. E-mail: siewveena.sahi@gmail.com

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-obgyn.com).

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