Background While the US Preventive Services Task Force recommends prophylactic ocular topical medication for all newborns to prevent gonococcal ophthalmia neonatorum, the Canadian pediatric society no longer recommends its use. Systematic prenatal screening for C. trachomatis (CT) and N. gonorrhoeae (NG), as well as treatment and test of cure (TOC) are considered the most effective ways of preventing vertical transmission and neonatal conjunctivitis. The aim of this study was to assess compliance with Quebec pregnancy screening guidelines.

Methods The list of all women who delivered at a tertiary care hospital in Montreal, between April 2015 and March 2016, was cross-referenced with the list of samples tested for CT/NG. Maternal medical records were reviewed for demographic, prenatal and diagnostic information.

Results Amongst 2688 women, 2256 were sampled at least once but only 2218 (82.5%) had at least one valid result available before the day of delivery. Screening rates leading to a valid result were higher among nulliparous women (86%; 1071/1243 vs 79%; 1138/1432; p<0.001) as well as in women <25 years old (yo) (86%; 298/347 vs 82%; 1920/2341; p=0.08). Infection was detected in 45/2218 (2%) women: CT (43; 1.9%) and NG (4; 0.2%); two were co-infected. CT infection was more frequent in women aged <25 yo (9.4%; 28/298) than among those aged ≥25 yo (0.8%; 15/1920; p<0.001). Amongst the 43 CT-infected women, 39 (91%) were treated and 31 (72%) had a TOC which was positive in four (13%) women. All NG-positive women were treated and had a negative TOC.

Conclusion Compliance with CT/NG screening and follow-up guidelines is insufficient to stop current universal ocular prophylaxis. Repeating universal screening in pregnancy should be considered: in addition to identifying women who become infected later in pregnancy, such strategy could decrease the number of women who are not screened at all during pregnancy.

Disclosure No significant relationships.