Relation of Chlamydia trachomatis infections to ectopic pregnancy

Abstract

Background: In a multitude of previous studies, Chlamydia trachomatis (CT) plays an important role in the occurrence of ectopic pregnancy (EP). However, the predictive value of CT infections in the occurrence of EP has not been estimated worldwide. We thus evaluated, by means of a meta-analysis, the current status of the association between CT infections with EP and the potential predictive value of CT infections in EP. Methods: We evaluated studies performed between the database construction time and August 2018 published in PubMed, the Cochrane Library, EMBASE, and the Web of Science (SCI). The relationship between CT and EP was calculated based upon the predetermined entry criteria for control group selection and the original data. The related articles were analyzed using a random-effects model, and the heterogeneity of the studies was assessed using the I2 index. Data were analyzed with the STATA 12.0 software. Results: Twenty-five studies that recruited 11960 patients were included in the present meta-analysis, and the relation of CT infections with EP were assessed. The association between CT infections and EP risk showed an odds ratio (OR) of 3.03, with a 95% confidence interval (CI) of 2.37 to 3.89. Our results showed that there was a statistically significant difference between the intervention and control groups. The prevalence of CT infections in EP was then calculated by a subgroup analysis: African (OR, 2.22; 95% CI, 1.14–4.31), European (OR, 3.16; 95% CI, 2.10–4.47), North American (OR, 3.07; 95% CI, 1.78–5.31), and Asian (OR, 3.39; 95% CI, 1.95–5.90). Conclusions: From the results of numerous studies conducted on different continents, this meta-analysis showed a clear association between EP and prior CT infections, that is, CT infections increase the risk of EP occurrence.

Bilateral Tubal Ectopic Pregnancy Following Clomiphene Administration: A Case Report

“…A meta-analysis completed by Xia et al looked at 25 studies with 11,960 patients and showed that there was a significant relationship between chlamydial infection and unilateral ectopic pregnancy (OR, 3.03; CI 95%, 2.37-3.89) [11]. While a history of STI is a well-established risk factor for developing a unilateral ectopic pregnancy, there is no case report of a bilateral ectopic pregnancy plus a history of an STI.…”

Ectopic pregnancies and endometrial microbiota

“…But, nowadays we know that micorogranisms that appear related to PID and infertility are independent from gonorrhoea and chlamydia. If several of these conditions are present simultaneously, the risk spikes (26).…”

Association Between Vaginal Gardnerella and Tubal Pregnancy in Women With Symptomatic Early Pregnancies in China: A Nested Case-Control Study

“…Although some progress has been made, there are currently no standard measures in place for the early diagnosis of tubal implantation ( Carusi, 2019 ; Chen et al., 2020 ; Sahin et al., 2021 ). Although the mechanism of TP is complex, the majority of relevant studies indicate that inflammation of the fallopian tube or the surrounding pelvic tissues, due to factors such as the presence of pelvic inflammatory disease (PID) or Chlamydia trachomatis (CT) infection ( Xia et al., 2020 ), is central to TP development ( Shao et al., 2009 ; Al-Azemi et al., 2010 ; Li et al., 2013 ). Therefore, the discovery of inflammation-associated biomarkers could help predict TP development.…”

“…Therefore, the discovery of inflammation-associated biomarkers could help predict TP development. Moreover, a nested case-control study with a large samples size ( N = 2,026) has revealed that abdominal pain [odds ratio (OR): 1.16, 95% confidence interval (CI): 0.92–1.48] and bleeding (OR:1.34, 95% CI: 1.04–1.78) are risk factors for EP ( Xia et al., 2020 ). The incidence of EP among pregnant women experiencing vaginal bleeding or abdominal pain (or both) in the first-trimester of pregnancy has been shown to be as high as 18% ( Barnhart et al., 2006 ).…”