This retrospective study evaluated STI screening rates, diagnosis, and prenatal care (PNC) linkage among pregnant patients visiting a large urban ED, focusing on those who later delivered at the same hospital (n=401) or had ectopic pregnancies (n=69), with an average gestational age of 9 weeks at ED presentation.
STI testing rates in the ED were low: only 13.2% were tested for HIV, 4.7% for syphilis, and 22.9% for gonorrhea/chlamydia. Over half (54.5%) of the 32 patients with gonorrhea/chlamydia and 80% of the 5 with syphilis were missed—not tested during their ED visit. Only 49.1% reported plans to access PNC.
Retrospective design limits causal inference; outcomes only captured for patients who delivered at the same hospital, likely undercounting the full cohort; PNC access was based on self-reported plans, not confirmed follow-up.
The ED visit in early pregnancy is a missed screening window—consider implementing routine opt-out STI testing (HIV, syphilis, gonorrhea/chlamydia) for pregnant patients presenting to the ED. Pairing screening with active PNC linkage could reduce preventable complications like congenital syphilis in underserved populations.
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