Gelingt das Screening von Schwangeren auf HIV, Syphilis und Hepatitis B in Deutschland? Eine Analyse auf Basis von Routinedaten

Background: Infections during pregnancy are one of the leading causes of increased morbidity and mortality in mothers and their newborns worldwide. In Germany, there has been standardized healthcare for pregnancy for more than 50 years. The maternity guidelines of the Joint Federal Committee form the legal framework for this and include the screening of pregnant women for HIV, syphilis, and hepatitis B, among other things. 

Aim of the work: The aim of this work is to determine the extent to which screening is covered by the German population. Material and methods: With the help of anonymized routine data of legally insured persons available to the Institut für angewandte Gesundheitsforschung Berlin GmbH (InGef) from 2011 to 2015, a definition of pregnancy was developed with the use of various ICD-10 and EBM codes and the first evaluation of the use of tests for infectious agents in pregnancy was carried out. 

Results: The high proportion of women who are tested for syphilis (95.3%) and hepatitis B (91.6%) during pregnancy indicates very good accessibility and use of prenatal screening services. For HIV, the proportion of women tested is significantly lower (84.9%). 

Discussion: Whether pregnant women refuse an HIV test, the test was performed elsewhere, or not recommended by the medical staff cannot be clarified on the basis of the available data. In view of the highly effective medical intervention options for syphilis, HIV, and hepatitis B, the aim should be to test pregnant women in Germany as completely as possible. The reasons for the lack of screening must be further investigated and starting points for increasing the use must be identified.