Midpregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis.
OBJECTIVE
The objective of the study was to estimate whether midpregnancy genitourinary tract infection with Chlamydia trachomatis is associated with an increased risk of subsequent preterm delivery.


METHODS
Infection with C. trachomatis was determined using a ligase chain reaction assay (performed in batch after delivery) of voided urine samples collected at the randomization visit (16(0/7) to 23(6/7) weeks' gestation) and the follow-up visit (24(0/7) to 29(6/7) weeks) among 2470 gravide women with bacterial vaginosis or Trichomonas vaginalis infection enrolled in 2 multicenter randomized antibiotic treatment trials (metronidazole versus. placebo).


RESULTS
The overall prevalence of genitourinary tract C. trachomatis infection at both visits was 10%. Preterm delivery less than 37 weeks' or less than 35 weeks' gestational age was not associated with the presence or absence of C. trachomatis infection at either the randomization (less than 37 weeks: 14% versus 13%, P=.58; less than 35 weeks: 6.4% versus 5.5%, P=.55) or the follow-up visit (less than 37 weeks: 13% versus 11%, P=.33; less than 35 weeks: 4.4% versus 3.7, P=.62). Treatment with an antibiotic effective against chlamydia infection was not associated with a statistically significant difference in preterm delivery.


CONCLUSIONS
In this secondary analysis, midtrimester chlamydia infection was not associated with an increased risk of preterm birth. Treatment of chlamydia was not associated with a decreased frequency of preterm birth.
Andrews
William W
WW
Department of Obstetrics and Gynecology, University of Alabama, Birmingham, AL, USA.
Klebanoff
Mark A
MA
Thom
Elizabeth A
EA
Hauth
John C
JC
Carey
J Christopher
JC
Meis
Paul J
PJ
Caritis
Steve N
SN
Leveno
Kenneth J
KJ
Wapner
Ronald J
RJ
Varner
Michael W
MW
Iams
J D
JD
Moawad
Atef
A
Miodovnik
Menachem
M
Sibai
Baha
B
Dombrowski
Mitchell
M
Langer
Oded
O
O'Sullivan
Mary J
MJ
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000188:drug therapy / Q000453:epidemiology*; D002692:Chlamydia trachomatis; D005260:Female; D006801:Humans; D022521:Ligase Chain Reaction; D016015:Logistic Models; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D047928:Premature Birth / Q000453:epidemiology*; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014247:Trichomonas Vaginitis / Q000453:epidemiology*; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000188:drug therapy / Q000453:epidemiology*
D000900:Anti-Bacterial Agents