Abstract
Preterm birth is a major public health problem, occurring in more than half a million births per year in the United States. A number of maternal conditions have been recognized as risk factors for preterm birth, but for the majority of cases, the etiology is not completely understood. Chlamydia trachomatis is one of the most prevalent sexually transmitted infections in the world. However, its role in adverse pregnancy outcome in women is still debated. In order to determine if genitourinary tract infection with C. trachomatis during pregnancy was associated with preterm birth, we conducted a case-control study on women who delivered at Boston Medical Center, an urban “safety-net” hospital that serves a socioeconomically disadvantaged and racially diverse population. Women with known risk factors for preterm birth or immune suppression were excluded. Variables collected on enrolled subjects included demographics; diagnosis of C. trachomatis during or prior to pregnancy; tobacco, alcohol, and illicit substance use; gestational age; and birthweight and gender of the newborn. We also collected urine for chlamydia testing at the time of delivery and placental biopsies for nucleic acid amplification and histological studies. A total of 305 subjects were enrolled: 100 who delivered preterm and 205 who delivered full term. Among those subjects, we identified 19 cases of pregnancy-associated C. trachomatis infection: 6/100 preterm and 13/205 full term, a difference which was not statistically significant. Only two cases of untreated chlamydia infection were identified postpartum, and both occurred in women who delivered at term. We conclude that genitourinary tract infection with C. trachomatis during pregnancy, when appropriately treated, is not associated with preterm birth.
Highlights
Preterm birth (PTB) is defined by the World Health Organization (WHO) as delivery before 37 weeks gestation
The primary goal of this study was to determine if preterm birth (PTB), or delivery before 37 weeks gestation, was associated with C. trachomatis infection during pregnancy
Subjects were enrolled in the study immediately postpartum and classified as PTB or full-term birth (FTB, controls)
Summary
Preterm birth (PTB) is defined by the World Health Organization (WHO) as delivery before 37 weeks gestation. Within the preterm birth category are subcategories of extremely preterm birth (less than 28 weeks), very preterm (28-32 weeks), and moderate to late preterm (32-37 weeks). It is estimated that 15 million babies are born prematurely each year, and prematurity is the leading cause of under-5 mortality worldwide [1]. In the United States and other developed countries, preterm birth is the leading cause of perinatal mortality for infants born without congenital abnormalities [2]. A review by the WHO in 2010 reported the highest rates of preterm birth in Africa, with North America a close second, and the lowest rates in Europe [3]. Statistics from the U.S are quite alarming, as preterm birth rates continue to rise.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
