Objectives: To measure the risk of preterm delivery, premature rupture of membranes, infant low birth weight and infant mortality, we conducted a population-based retrospective cohort study using Washington State birth certificate data.
Methods: We identified all women diagnosed with Chlamydia trachomatis infection (n = 851) noted with a check box on the birth certificate from 2003 and a randomly selected sample of women not diagnosed with Chlamydia trachomatis (n=3,404). To assess the relative risk between chlamydia infection and pregnancy outcomes, we used multivariable logistic regression analysis.
Results: Women with chlamydia infection were younger, more likely to be non white and had less years of education compared to women without chlamydia. Additionally, they were more likely to have inadequate prenatal care and co-infections with other sexually transmitted infections (STIs). After adjusting for age and education, chlamydia-infected women were at increased risk of preterm delivery (relative risk [RR] = 1.46, 95% confidence interval [CI] = 1.08-1.99) and premature rupture of membranes (RR = 1.50, 95% CI = 1.03- 2.17) compared to non-infected women. However, no increased risk of infant death (RR=1.02, 95% CI = 0.37- 2.80) or low birth weight (RR=1.12, 95% CI = 0.74-1.68) associated with chlamydia infection was observed.
Conclusion: This study suggests that Chlamydia trachomatis is associated with increased risk of preterm delivery and premature rupture of membranes, but not infant death and low birth weight. Routine screening and opportune treatment for Chlamydia trachomatis should be considered a necessary part of prenatal care to reduce these adverse pregnancy outcomes.
- Cohort Study
- Sexually Transmitted Infections
- Washington State