Cost-effectiveness of prenatal testing for Chlamydia trachomatis

Am J Obstet Gynecol. 1991 May;164(5 Pt 1):1289-94. doi: 10.1016/0002-9378(91)90701-r.


We investigated the cost-effectiveness of strategies for screening pregnant women for Chlamydia trachomatis. Screening was not cost-effective unless certain conditions were met. Direct antigen testing of all pregnant women would be cost-effective if the test cost less than $6.30 or the prevalence of infection exceeded 6%. However, the positive predictive value of the test was only 51%. Culturing was not cost-effective until the prevalence of infection exceeded 14.8%. If a direct antigen test cost less than $3.90 or prevalence exceeded 8.7%, direct antigen testing of all women and using culture to confirm positive direct antigen tests would be cost-effective. If a direct antigen test cost $8.00 and culture cost $25.00, the excess cost of performing a direct antigen test in all women and confirming positive results with culture would be $2.09 per pregnant woman. Screening all pregnant women for chlamydia is not cost-effective, but the excess cost is modest when direct antigen tests are used.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology
  • Chlamydia trachomatis*
  • Cost-Benefit Analysis
  • Female
  • Humans
  • Predictive Value of Tests
  • Pregnancy
  • Prenatal Diagnosis / economics*