Objective: Evaluation of the effectiveness of antenatal screening in the Netherlands for HIV, hepatitis B virus (HBV) and syphilis, in preventing mother-to-child transmission.
Design: Descriptive.
Methods: The results of antenatal screening in the period 2006-2008 were compared with data from pregnant women and newborns from other data sources.
Results: Each year, around 185,000 pregnant women were screened for HIV, HBV and syphilis. Refusal rates for the screening tests were low, and were highest (0.2%) for HIV. Prior to the introduction of screening, 5-10 children were born with HIV annually. After the introduction of screening in 2004, only 4 children were born with HIV (an average of 1 per year). Two of these mothers had become pregnant prior to 2004; the third mother was HIV negative at screening and probably became infected after screening; the fourth mother's background was unknown. Congenital syphilis was diagnosed in fewer than 5 newborns annually and 5 children were infected with HBV. In 3 of these the mothers were HBeAg positive (a marker for high infectivity). We estimated that 5-10 HIV, 50-75 HBV and 10 syphilis cases in newborns had been prevented annually as a result of screening.
Conclusion: The screening programme was effective in detecting HIV, HBV and syphilis in pregnant women and in preventing transmission to the child. Since the introduction of the HIV screening the number of children born with HIV has fallen dramatically.