Article information
Abstract
Objective
To evaluate the effect of Chlamydia trachomatis infection during pregnancy on perinatal morbidity and mortality.
MethodsSystematic review and meta-analysis in an electronic database and manual, combining high sensitivity specific descriptors seeking to answer the research objective. The articles considered to be of high methodological quality (score above 6 on the Newcastle-Ottawa Scale) were assessed by meta-analysis.
ResultsSummary estimates of 12 studies were calculated by means of Mantel-Haenszel test with 95% confidence interval. It was observed that Chlamydia infection during pregnancy increased risk of preterm labor (relative risk (RR)=1.35 [1.11, 1.63]), low birth weight (RR=1.52 [1.24, 1.87]) and perinatal mortality (RR=1.84 [1.15, 2.94]). No evidence of increased risk was associated with Chlamydia infection in regard to premature rupture of membranes (RR=1.13 [0.95, 1.34]), abortion and postpartum endometritis (RR=1.20 [0.65, 2.20] and 0.89 [0.49, 1.61] respectively).
ConclusionThe diagnosis and treatment of Chlamydia cervicitis during pregnancy can reduce perinatal morbidity and mortality associated with this infection. However, clinical trials are needed to confirm these findings.
Keywords:
Chlamydia trachomatis
perinatal mortality
morbidity
meta-analysis
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References
[1.]
A. Al-Fouzan, N. Al-Mutairi.
Overview of incidence of sexually transmitted diseases in Kuwait.
Clin Dermatol, 22 (2004), pp. 509-512
[2.]
Centers for Disease Control and Prevention.
Chlamydia screening among sexually active young female enrollees of health plans – United States, 1999–2001.
MMWR Morb Mortal Wkly Rep, 53 (2004), pp. 983-985
[3.]
P. Chotnopparatpattara, S. Limpongsanurak, A. Wongprechasawas.
The prevalence of Chlamydia trachomatis infection in pregnant Thai women.
J Med Assoc Thai, 86 (2003), pp. S399-S403
[4.]
M.J. Currie, F.J. Bowden.
The importance of chlamydial infections in obstetrics and gynaecology: an update.
Aust N Z J Obstet Gynaecol, 47 (2007), pp. 2-8
[5.]
Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2005. 2006.
[6.]
World Health Organization. Global prevalence and incidence of selected curable sexually transmitted diseases: overview and estimates.Geneva; 2001.
[7.]
K.W. Beagley, P. Timms.
Chlamydia trachomatis infection: incidence, health costs and prospects for vaccine development.
J Reprod Immunol, 48 (2000), pp. 47-68
[8.]
K. Manavi.
A review on infection with Chlamydia trachomatis.
Best Pract Res Clin Obstet Gynaecol, 20 (2006), pp. 941-951
[9.]
M.R. Barcelos, P.R. Vargas, C. Baroni, A.E. Miranda.
Genital infections in women attending a Primary Unit of Health: prevalence and risk behaviors.
Rev Bras Ginecol Obstet, 30 (2008), pp. 349-354
[10.]
E.M. Jalil, V.M. Pinto, A.S. Benzaken, et al.
Prevalência da infecção por clamídia e gonococo em gestantes de seis cidades brasileiras.
Rev Bras Ginecol Obstet, 30 (2008), pp. 614-619
[11.]
C. Bebear, B. de Barbeyrac.
Genital Chlamydia trachomatis infections.
Clin Microbiol Infect, 15 (2009), pp. 4-10
[12.]
K. Avasthi, T. Garg, S. Gupta, R.K. Grewal, S. Ram.
A study of prevalence of Chlamydia trachomatis infection in women with first trimester pregnancy losses.
Indian J Pathol Microbiol, 46 (2003), pp. 133-136
[13.]
M.M. Blas, F.A. Canchihuaman, I.E. Alva, S.E. Hawes.
Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State.
Sex Transm Infect, 83 (2007), pp. 314-318
[14.]
J.F. Peipert.
Clinical practice. Genital chlamydial infections.
N Engl J Med, 349 (2003), pp. 2424-2430
[15.]
I.J. Bakken, F.E. Skjeldestad, S.A. Nordbo.
Chlamydia trachomatis infections increase the risk for ectopic pregnancy: a population-based, nested case-control study.
Sex Transm Dis, 34 (2007), pp. 166-169
[16.]
C. Bebear, B. de Barbeyrac.
Genital Chlamydia trachomatis infections.
Clin Microbiol Infect, 15 (2009), pp. 4-10
[17.]
E. Kirk, S. Bora, B. Van Calster, et al.
Chlamydia trachomatis infection in patients attending an Early Pregnancy Unit: prevalence, symptoms, pregnancy location and viability.
Acta Obstet Gynecol Scand, 87 (2008), pp. 601-607
[18.]
J. Fitz Simmons, C. Callahan, B. Shanahan, D. Jungkind.
Chlamydial infections in pregnancy.
J Reprod Med, 31 (1986), pp. 19-22
[19.]
D.H. Much, S.Y. Yeh.
Prevalence of Chlamydia trachomatis infection in pregnant patients.
Public Health Rep, 106 (1991), pp. 490-493
[20.]
W.W. Andrews, M.A. Klebanoff, E.A. Thom, et al.
Midpregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis.
Am J Obstet Gynecol, 194 (2006), pp. 493-500
[21.]
L. Chamani-Tabriz, M.J. Tehrani, M.M. Akhondi, et al.
Chlamydia trachomatis prevalence in Iranian women attending obstetrics and gynaecology clinics.
Pak J Biol Sci, 15 (2007), pp. 4490-4494
[22.]
K. Cheney, L. Wray.
Chlamydia and associated factors in an under 20s antenatal population.
Aust N Z J Obstet Gynaecol, 48 (2008), pp. 40-43
[23.]
R. Leite.
Infecção cervical causada por Chlamydia Trachomatis em gestantes. Estudo de prevalência e fatores de risco.
Rev Bras Gin Obst, 23 (2001), pp. 58-59
[24.]
A. Baczynska, M. Hvid, P. Lamy, S. Birkelund, G. Christiansen, J. Fedder.
Prevalence of Mycoplasma genitalium, Mycoplasma hominis and Chlamydia trachomatis among Danish patients requesting abortion.
Syst Biol Reprod Med, 54 (2008), pp. 127-134
[25.]
P.A. Mardh.
Influence of infection with Chlamydia trachomatis on pregnancy outcome, infant health and life-long sequelae in infected offspring.
Best Pract Res Clin Obstet Gynaecol, 16 (2002), pp. 847-864
[26.]
D. Kadzhaia, N. Merabishvili.
Prevalence and risk factors for Chlamydia trachomatis infection in pregnant women.
Georgian Med News, (2005), pp. 33-36
[27.]
F.A.C. Vaz, M.E.J. Ceccon, E.M.A. Diniz.
Infecção por Chlamydia trachomatis no período neonatal: aspectos clínicos e laboratoriais. Experiência de uma década: 1987–1998.
Rev Ass Med Bras, 45 (1999), pp. 303-311
[28.]
M.G. Gravett, H.P. Nelson, T. DeRouen, C. Critchlow, D.A. Eschenbach, K.K. Holmes.
Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome.
JAMA, 256 (1986), pp. 1899-1903
[29.]
A. Jain, V.L. Nag, M.M. Goel, Chandrawati, U.C. Chaturvedi.
Adverse foetal outcome in specific IgM positive Chlamydia trachomatis infection in pregnancy.
Indian J Med Res, 94 (1991), pp. 420-423
[30.]
D.H. Martin, L. Koutsky, D.A. Eschenbach, et al.
Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections.
JAMA, 247 (1982), pp. 1585-1588
[31.]
S.M. Berman, H.R. Harrison, W.T. Boyce, W.J. Haffner, M. Lewis, J.B. Arthur.
Low birth weight, prematurity, and postpartum endometritis. Association withprenatal cervical Mycoplasma hominis and Chlamydia trachomatis infections.
JAMA, 257 (1987), pp. 1189-1194
[32.]
H.R. Harrison, E.R. Alexander, L. Weinstein, M. Lewis, M. Nash, D.A. Sim.
Cervical Chlamydia trachomatis and mycoplasmal infections in pregnancy. Epidemiology and outcomes.
JAMA, 250 (1983), pp. 1721-1727
[33.]
L. Kovacs, E. Nagy, I. Berbik, G. Meszaros, J. Deak, T. Nyari.
The frequency and the role of Chlamydia trachomatis infection in premature labor.
Int J Gynaecol Obstet, 62 (1998), pp. 47-54
[34.]
P. Oakeshott, P. Hay, S. Hay, F. Steinke, E. Rink, S. Kerry.
Association between bacterial vaginosis or chlamydial infection and miscarriage before 16 weeks’ gestation: prospective community based cohort study.
BMJ, 325 (2002), pp. 1334
[35.]
M.F. Silveira, K.G. Ghanem, E.J. Erbelding, et al.
Chlamydia trachomatis infection during pregnancy and the risk of preterm birth: a case-control study.
Int J STD AIDS, 20 (2009), pp. 465-469
[36.]
J. Yu, S. Wu, F. Li, L. Hu.
Vertical transmission of Chlamydia trachomatis in Chongqing China.
Curr Microbiol, 58 (2009), pp. 315-320
[37.]
J.M. Miller, R.T. Maupin, M. Nsuami.
Initial and repeat testing for Chlamydia during pregnancy.
Am Fam Physician, 18 (2005), pp. 231-235
[38.]
L. Rahangdale, S. Guerry, H.M. Bauer, et al.
An observational cohort study of Chlamydia trachomatis treatment in pregnancy.
Sex Transm Dis, 33 (2006), pp. 106-110
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