Article thumbnail

Chlamydia trachomatis infection during pregnancy associated with preterm delivery: a population-based prospective cohort study

By G. Ingrid J. G. Rours, Liesbeth Duijts, Henriette A. Moll, Lidia R. Arends, Ronald de Groot, Vincent W. Jaddoe, Albert Hofman, Eric A. P. Steegers, Johan P. Mackenbach, Alewijn Ott, Hendrina F. M. Willemse, Elizabeth A. E. van der Zwaan, Roel P. Verkooijen and Henri A. Verbrugh


Chlamydia trachomatis infection is the most prevalent bacterial sexually transmitted infection and may influence pregnancy outcome. This study was conducted to assess the effect of chlamydial infection during pregnancy on premature delivery and birthweight. Pregnant women attending a participating midwifery practice or antenatal clinic between February 2003 and January 2005 were eligible for the study. From 4,055 women self-administered questionnaires and urine samples, tested by PCR, were analysed for C. trachomatis infection. Pregnancy outcomes were obtained from midwives and hospital registries. Gestational ages and birthweights were analysed for 3,913 newborns. The C. trachomatis prevalence was 3.9%, but varied by age and socio-economic background. Chlamydial infection was, after adjustment for potential confounders, associated with preterm delivery before 32 weeks (OR 4.35 [95% CI 1.3, 15.2]) and 35 weeks gestation (OR 2.66 [95% CI 1.1, 6.5]), but not with low birthweight. Of all deliveries before 32 weeks and 35 weeks gestation 14.9% [95% CI 4.5, 39.5] and 7.4% [95% CI 2.5, 20.1] was attributable to C. trachomatis infection. Chlamydia trachomatis infection contributes significantly to early premature delivery and should be considered a public health problem, especially in young women and others at increased risk of C. trachomatis infection

Topics: Infectious Diseases
Publisher: Springer Netherlands
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2005). A prediction rule for selective screening of Chlamydia trachomatis infection. Sex Transm Infect.
  2. A review on infection with Chlamydia trachomatis.
  3. (2002). A systematic review of the prevalence of Chlamydia trachomatis among European women. Hum Reprod Update.
  4. (1991). An update of the Swedish reference standards for weight, length and head circumference at birth for given gestational age (1977–1981). Acta Paediatr Scand.
  5. (2005). Antenatal care in the European Union: a survey on guidelines in all 25 member states of the Community. Eur J Obstet Gynecol Reprod Biol.
  6. Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy.
  7. Association of Chlamydia trachomatis and Mycoplasma hominis with intrauterine growth retardation and preterm delivery. The John Hopkins Study of Cervicitis and Adverse Pregnancy Outcome.
  8. Cervical Chlamydia trachomatis and mycoplasmal infections in pregnancy. Epidemiology and outcomes.
  9. Chlamydia trachomatis as a cause of neonatal conjunctivitis in Dutch infants.
  10. Chlamydia trachomatis in the United Kingdom: a systematic review and analysis of prevalence studies.
  11. Chlamydia trachomatis infection and pregnancy outcome.
  12. Chlamydia trachomatis infection during pregnancy and the risk of preterm birth: a case-control study.
  13. Chlamydia trachomatis infection in pregnancy: risk factor for an adverse outcome.
  14. (2005). Chlamydia trachomatis infections in neonates and young children. Semin Pediatr Infect Dis.
  15. (2009). Chlamydia trachomatis respiratory infection in Dutch infants. Arch Dis Child.
  16. Chlamydia trachomatis seropositivity is associated both with stillbirth and preterm delivery.
  17. (2001). Chlamydial infection and unplanned pregnancy in women with ready access to health care. Obstet Gynecol.
  18. Clinical practice. Genital chlamydial infections.
  19. Disease Control and Prevention. Sexually transmitted diseases treatment guidelines.
  20. (1997). Double-blind placebo-controlled treatment trial of Chlamydia trachomatis endocervical infections in pregnant women. Infect Dis Obstet Gynecol.
  21. (1995). Endocervical pathogens in women with preterm and term labour. Gynecol Obstet Invest.
  22. Health Council of the Netherlands. Screening for Chlamydia, nr 2004/07.
  23. Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome.
  24. (1993). Infection due to Chlamydia trachomatis in pregnancy and the newborn. Baillieres Clin Obstet Gynaecol.
  25. (2002). Influence of infection with Chlamydia trachomatis on pregnancy outcome, infant health and life-long sequelae in infected offspring. Best Pract Res Clin Obstet Gynaecol.
  26. (2002). Lower genital tract infection and endometritis: insight into subclinical pelvic inflammatory disease. Obstet Gynecol.
  27. Maternal genital Chlamydia trachomatis infection and the risk of preterm labor.
  28. Midpregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis.
  29. (1998). Modern epidemiology. second ed: LippincottRaven
  30. (2007). Pregnancy outcomes in women infected with Chlamydia trachomatis:a population-based cohort study in Washington State. Sex Transm Infect.
  31. Prematurity and perinatal mortality in pregnancies complicated by maternal Chlamydia trachomatis infections.
  32. Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study.
  33. (2008). Screening pregnant women for chlamydia: what are the predictors of infection? Sex Transm Infect.
  34. Serologic evidence of Chlamydia trachomatis infection and risk of preterm birth.
  35. Services Task Force. Screening for Chlamydial infection: U.S. preventive services task force recommendation statement.
  36. The association between Chlamydia trachomatis genital infection and spontaneous preterm labour.
  37. The association of Chlamydia trachomatis, Neisseria gonorrhoeae, and group B streptococci with preterm rupture of the membranes and pregnancy outcome.
  38. The frequency and the role of Chlamydia trachomatis infection in premature labor.
  39. The generation r study biobank: a resource for epidemiological studies in children and their parents.
  40. (2010). The generation R study: design and cohort update
  41. (2003). The Netherlands Perinatal Registry. Perinatal Care in the Netherlands
  42. (2000). The preterm prediction study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecol.
  43. Use of pooled urine samples and automated DNA isolation to achieve improved sensitivity and cost-effectiveness of large-scale testing for Chlamydia trachomatis in pregnant women.