618 Adverse pregnancy and neonatal outcomes associated with chlamydial infection in pregnancy

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To determine whether chlamydial infection in pregnancy is associated with adverse pregnancy and neonatal outcomes. Retrospective analysis of the Centers for Disease Control and Prevention, Natality Live Birth database (2016-2018). The study group included women with chlamydial infection in pregnancy, while all births from pregnancies with no chlamydial infection served as controls. The rates of several adverse pregnancy and neonatal outcomes were compared between the two groups using Pearson’s Chi-squared test with Bonferroni adjustments. Multivariate logistic regression was used to adjust outcomes for potential confounders such as maternal age, body mass index, race/ethnicity, and prior preterm birth (PTB). Results were presented as adjusted Odds Ratios (aOR) with 95% confidence intervals (CI). Statistical significance was defined as a P value < 0.05. Infection with chlamydia complicated 1.8% of the study cohort (186,504/10,422,279). The rates of adverse pregnancy and neonatal outcomes in both groups, as well as the aOR for each outcome are displayed in the table. Chlamydial infections were associated with several adverse pregnancy and neonatal outcomes, including a significantly increased risk for PTB prior to 37 weeks and 32 weeks, low birthweight, congenital malformations, low 5 minute APGAR scores, NICU admissions, antibiotic treatment of the neonate, immediate ventilation, as well as prolonged ventilation (see Table). Based on this large US population cohort, chlamydial infections during pregnancy are associated with significant risks for several adverse pregnancy and neonatal complications, as well as congenital malformations. Our study emphasizes the need for improving targeted strategies for infection prevention, and access to timely screening and treatment in efforts to reduce the likelihood of adverse pregnancy and neonatal outcomes. Given the recent rise in sexually transmitted diseases during the COVID-19 pandemic and decreased frequency of in-person prenatal care visits, this task is even more challenging.