Maternal Chlamydia trachomatis Infections and Preterm Births in a University Hospital in Vitoria, Brazil

Abstract

BackgroundPreterm birth (PTB) is a major determinant of neonatal morbimortality with adverse consequences for health. The causes are multifactorial, with intrauterine infection probably explaining most of these outcomes. It is believed that infection with Chlamydia trachomatis (CT) is also involved in PTB and premature rupture of membranes.ObjetivesTo evaluate the prevalence of and associated factors for CT among cases of PTB attended at a University Hospital in Vitoria, Brazil.MethodsA cross-sectional study performed among parturient who had preterm birth from June 2012 to August 2013 in Vitoria, Brazil. Participants answered a questionnaire including demographic, behavioral, and clinical data. A sample of urine was collected and screened for CT using polymerase chain reaction. Chi-square tests were used for proportion differences and Student’s-t tests and variance analysis were used for testing differences between mean values. Odds ratio was used as a measure of association with a 95% confidence interval.ResultsThe prevalence of PTB during the period of the study was 26% and the prevalence of CT among them was 13.9%. A total of 31.6% pregnant women were younger than 25 years old and women infected by CT were even younger than women not infected by CT (p = 0.022). Most of them (76.2%) were married or had a living partner, and CT infection was more frequent among the single ones (p = 0.018); 16.7% of women reported their first sexual intercourse under 14 years old. The causes of prematurity were maternal-fetal in 40.9%; rupture of the membranes in 29.7% and premature labor in 29.4%. In multivariate analysis, being married was a protective factor for infection [OR = 0.48 (95%CI:0.24–0.97)]. None of the other characteristics were associated with CT infection.ConclusionsThis study shows a high prevalence of CT infection among parturient who have preterm birth. This high prevalence highlight the need for defining screening strategies focused on young pregnant women in Brazil.

Association between Chlamydia Trachomatis Cervicitis and Preterm Labor

“…Results of our study are compatible with those found by Schmidt et al (29) who evaluated the prevalence of and associated factors for CT among cases of PTB attended at a University Hospital in Vitoria, Brazil by cross-sectional study performed among parturient who had preterm birth from June 2012 to August 2013. Odds ratio was used as a measure of association with a 95% confidence interval.…”

“…This is consistent with the study conducted by Andrews et al (33) where there were no statistical difference between cases of preterm labor and controls regarding the maternal age and the parity. It is in contrast to the study conducted by Schmidt et al (29) where there were a statistical significant difference between two groups as regard maternal age (p = 0.022).…”

Alta incidência da infecção urogenital por Chlamydia trachomatis em mulheres parturientes de Belém, Estado do Pará, Brasil

“…Foi encontrada uma alta incidência (18%) da infecção urogenital por C. trachomatis em jovens parturientes de uma maternidade de referência de Belém do Pará, o que representa a maior frequência dessa IST em populações de jovens grávidas do Brasil, pois se manteve superior às prevalências identificadas em outras regiões do país, que variaram de 9,4% a 13,9% 7,8,9,10 . A incidência encontrada também é superior a de outros estudos que investigaram a infecção por C. trachomatis em grávidas de diversas regiões no mundo, mostrando prevalências que variaram de 1,1% a 11,1%…”

“…Neste estudo, foi encontrada a associação significativa da infecção urogenital por C. trachomatis em jovens de idade igual ou inferior a 25 anos, o que é amplamente relatado em várias populações no mundo 10,16,17,18 . Por ser observada ampla exposição aos fatores de risco para as IST nesse período de vida, alguns países desenvolveram os serviços de rastreio no pré-natal, estabelecidos prioritariamente para as mulheres jovens, de até 25 anos de idade 19,20,21,22 .…”

“…Isso torna subestimada a epidemiologia dessa infecção. Em algumas cidades brasileiras, infecções em parturientes por C. trachomatis apresentam frequências que variam de 9,4% a 13,9% 7,8,9,10 . O objetivo deste estudo foi verificar a incidência da infecção urogenital por C. trachomatis em parturientes de uma maternidade pública de referência em Belém, Estado do Pará, Brasil, descrevendo os indicadores sociocomportamentais e de reprodução possivelmente associados.…”