ECDC has published Antenatal screening in Europe: how to avoid mother-to-child transmission of infections. Excerpt:
Each year, more than five million live births are recorded in the European Union. Almost as many pregnant women are screened for infections – namely for HIV, syphilis, hepatitis B and rubella susceptibility – in order to prevent possible mother-to-child transmission (MTCT). However, children are still being born with these infections in the EU/EEA. For example, 424 congenital syphilis infections and 274 HIV infections were reported in children born between 2010 and 2014.
In its evidence-based guidance, ECDC aims to help Member States to strengthen antenatal screening in the general population and in particular among vulnerable groups for MTCT. The guidance looks at which elements of a national antenatal screening programme for infections influence effectiveness, and which are the specific approaches to be used for reaching the vulnerable groups in order to increase the uptake of prenatal care and reduce mother-to-child transmission. The guidance is accompanied by two technical reports of literature reviews.
Among the main proposals for effective antenatal screening are:
• Testing for HIV, syphilis and hepatitis B during the first trimester of pregnancy.
• Repeat testing offer during the third trimester for pregnant women at increased risk of infection and/or for those who previously refused testing.
• Testing at delivery to women who had not previously been tested.
• For HIV and syphilis in particular, a universal approach should be considered for the antenatal screening, which means voluntary testing for all pregnant women with an opt-out possibility.
To improve the uptake of antenatal testing among vulnerable groups like migrant women or women at higher risk for infections due to injecting drug use or those engaging in high risk sexual practices, several options may be considered. This includes addressing communication barriers regarding language, literacy levels, or individual or cultural specifics, and improving access to antenatal care through outreach services and informal networks can help.