Reiterating its earlier recommendations, the US Preventive Services Task Force (USPSTF) has recommended that all sexually active women ≤24 years and women ≥25 years who are at increased risk for infection, including pregnant persons should be screened for chlamydia and gonorrhea. 

In its recommendation statement published in JAMA on September 14, the Task Force concluded "with moderate certainty" that screening for both chlamydia and gonorrhea in these women has "moderate net benefit". But there is “little evidence” on the effectiveness of screening in “low-risk women”. The USPSTF further says that current data is inadequate to “assess the balance of benefits and harms of screening for chlamydia and gonorrhea in men”.

Nucleic acid amplification tests (NAATs) for Chlamydia trachomatis and Neisseria gonorrhoeae infections are generally employed as screening tests in view of their high sensitivity and specificity in diagnosing these infections. A history of any new risk factor or persistent risk factors since the last negative test can serve as a guide to determine the screening interval. Both chlamydia and gonorrhea are amenable to antibiotic treatment. But given the high antibiotic resistance rates for gonorrhea, antibiotics as per standard guidelines should be prescribed.

Chlamydia and gonorrhea are among the most prevalent sexually transmitted infections (STIs) and the infection rates are highest among women aged 15-24 years. Moreover, these infections, particularly Chlamydia, are “silent” as they are usually asymptomatic. Undiagnosed and untreated infections may cause pelvic inflammatory disease (PID) and its associated complications, such as ectopic pregnancy, infertility, and chronic pelvic pain. In untreated pregnant women, the outcome in newborns can be neonatal chlamydial pneumonia or gonococcal or chlamydial ophthalmia.

Reference

1. US Preventive Services Task Force, Davidson KW, et al. Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement. JAMA. 2021;326(10):949-956.