Chlamydia trachomatis infection and maternal outcomes in Southern Ghana

Abstract

Background: Despite the fact that Chlamydia trachomatis (CT) infection in pregnancy is known to have grave impact on maternal and neonatal health, routine CT screening in pregnancy is not available in Ghana The main aim of this study was to determine the prevalence and adverse maternal outcomes of CT infection among pregnant women attending antennal clinic at the Cape Coast Teaching Hospital. Methods: Two hundred and thirty two (232) pregnant women screened for CT infection by PCR were purposively selected and enrolled into the study after informed consent had been obtained. They included one hundred and twelve (112) participants with positive CT (cases) and 120 participants without CT infections (control). A structured questionnaire was used to collect their socio demographic, obstetric and medical history. They were monitored thereafter and data on maternal outcomes were collected. Results: The prevalence of CT infection was 5.6% (112/2014). A history of STI/UTI (p<0.001) spontaneous abortion (p=0.02), preterm labour (p<0.001) and intrapartum or postpartum fever (p<0.001) were found to be associated with CT infection. However a history of Stillbirth, PID and having been treated for infertility were not associated with CT infection. Participants with CT infection were more likely to have PROM (p<0.001) and FSL (p<0.001) than those who were not infected. Parity and mode of delivery on the other hand were not associated with CT infection. Conclusions: To alleviate the adverse maternal outcomes, screening for CT infection in pregnancy should be offered routinely to pregnant women to promote early detection and treatment.

Trans-Placental Transmission and Survival at Birth among Neonates of Chlamydia trachomatis Infected Mothers: A Cohort Study

“…These adverse pregnancy outcomes have been identified to be associated with neonatal sepsis (10). Similarly, adverse neonatal outcomes that were known to be associated with vertical transmission have also been reported by previous studies as preterm delivery, low birth weight and Apgar score less than 7 at minutes one and five (3,10,11). Spontaneous abortion and stillbirth have also been reported to be significantly associated with CT infection (11).…”

“…CT infection has been implicated in several adverse obstetric outcomes; premature rapture of membrane, amnionitis, intrapartum fever, and meconium stained amniotic fluid (8,9). These adverse pregnancy outcomes have been identified to be associated with neonatal sepsis (10). Similarly, adverse neonatal outcomes that were known to be associated with vertical transmission have also been reported by previous studies as preterm delivery, low birth weight and Apgar score less than 7 at minutes one and five (3,10,11).…”

“…CT DNA was observed to be more common in products of conception and the placenta in women with miscarriage than in their control counterparts (15). Miscarriage, stillbirth and ectopic pregnancy were reported to be higher in CT infected pregnant women than their uninfected counterparts (10,19,20). One such study found CT antibodies in 33.3% of mothers with stillbirths in comparison to 10.4% of mothers with live births (?…”

“…Risk factors for adverse pregnancy outcome in CT infections have been reported by several studies (4,15,24,30). These risk factors have been used to identify individuals at risk for prophylactic antibiotics (10).…”

“…Maternal cervical samples were obtained from pregnant women on their first ANC visit, when they were recruited and their epidemiological data were obtained (10). The cervical samples were obtained using a cytopathological brush for sampling of the cervix.…”