Association between Chlamydial Infection with Ectopic and Full-Term Pregnancies: A Case-Control Study

Abstract

Ectopic pregnancies (EPs) are potentially fatal if not recognized early. Evidence of an association with chlamydial infection in South East Asia is lacking. This case-control study aims to (i) compare chlamydial infection in women with EP to women who delivered a full-term pregnancy, (ii) investigate classical factors associated with EP, and (iii) investigate rupture status in EP. Seventy-two women with a confirmed diagnosis of EP and sixty-nine who delivered a full-term pregnancy in a tertiary hospital in Malaysia were recruited from November 2019 to January 2022. Demographic and relevant clinical data and intraoperative findings were documented. Blood samples for testing IgG levels of chlamydia were obtained. Women with EP were more likely to have tested positive for chlamydia than those with a full-term delivery (34.7% vs. 13.0%, AOR = 4.18, 95% CI = 1.67–10.48, p = 0.002). The majority did not have the classic risk factors associated with EP. An amount of 52.8% presented with a ruptured EP, with 84.2% of ruptures occurring after six weeks of gestation. An amount of 44.2% had an estimated blood loss of more than 500 cc, with 20% losing more than 1500 cc of blood. The prevalence of prior chlamydial infection in women with EP is significant enough to necessitate a review of early pregnancy care.

A Landscape View of the Female Genital Tract Microbiome in Healthy Controls and Women With Reproductive Health Conditions Associated With Ectopic Pregnancy

“…Various studies have described the strong associations between prior CT infections with ectopic pregnancy, where tubal damage was one of the potential mechanisms underlying this correlation [71,72]. A recent study assessing the presence of chlamydia IgG in women with a confirmed diagnosis of ectopic pregnancy showed that the odds for chlamydia infection were higher compared to normal pregnancies [73].…”

Emerging Diseases/Viruses Prevention, Control, Surveillance, and One Health

“…A case report by Safiee et al indicates that the various infecting Leptospira species and the presence of a range of virulence factors result in a modest variation in the clinical manifestations and laboratory findings of leptospirosis [ 23 ]. Another study conducted in Malaysia demonstrates that women who experience an ectopic pregnancy are more likely to have tested positive for chlamydia than those who give birth at term [ 24 ]. Zheng et al from Shanghai, China, investigate the bacterial communities and the prevalence of some primary pathogens in Haemaphysalis spp., the dominant species of ticks in Shanghai [ 25 ].…”