Abstract
Objectives: Chlamydia trachomatis infection is generally considered to be a risk factor to pregnancy. The aim of this study was to determine the role of Chlamydia trachomatis in miscarriage, as well as consider different diagnostic approaches. Materials and methods: We collected serum, cervicovaginal swab specimens, and placental samples women with vaginal bleeding and/or abdominal pain in their first trimester of pregnancy. The presence of chlamydial infection was detected by conventional cultivation, by detection of chlamydial antigen using Polymerase Chain Reaction (PCR) and detection of IgG level using Immune-Enzymatic Assay (ELISA). Results: Prevalence of miscarriage was significantly higher in group with positive cultivation of C. trachomatis infection (67.3% vs. 36.0%). We did not find a significant difference between the detection of chlamydial infection using conventional cultivation, ELISA or PCR. Association between a C. trachomatis positive diagnostic test and miscarriage remained significant (OR=2.41; 95% CI 1.32-3.35, p<0.01). Conclusion: C. trachomatis infection is an important causative factor of miscarriage. C. trachomatis infection diagnostic procedures should be considered for further recommendations especially for women with recurrent fetal losses.
Highlights
Chlamydia trachomatis (C. trachomatis) infection is one of the most prevalent sexually transmitted diseases worldwide
Prevalence of miscarriage was significantly higher in group with positive cultivation of C. trachomatis infection (67.3% vs. 36.0%)
We did not find a significant difference between the detection of chlamydial infection using conventional cultivation, ELISA or Polymerase Chain Reaction (PCR)
Summary
Chlamydia trachomatis (C. trachomatis) infection is one of the most prevalent sexually transmitted diseases worldwide. The incidence of the Chlamydia trachomatis infection has dramatically increased during the past 10 years [1]. More than 80% of cases are asymptomatic, among females, and can lead to continued transmission of the infection and chronic infection with a high risk of pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, salpingitis or tubal factor of infertility. C. trachomatis is a recognized agent of preterm labour and premature rupture of membranes; women are predisposed to postpartum pelvic inflammatory diseases and the neonatal complications of infant low birth, conjunctivitis and pneumonia [2,3]. Its role in miscarriage is unclear, but women after miscarriage, with unrecognised chlamydial infection, are at a higher risk of ascending infection [4]
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