Association of Past <i>Chlamydia trachomatis</i> Infection With Miscarriage

Horne, Andrew; Wheelhouse, Nick; Horner, Patrick J; Duncan, W. Colin

doi:10.1001/jamanetworkopen.2020.18799

Cited by 6 publications

(5 citation statements)

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“…Four cases of tubal damage and two of PID were identified thanks to the screening, while there were six cases of miscarriage (5%) in women infected with C. trachomatis . The role of this bacterial species in miscarriage is still controversial 54,55 . In large population‐based studies, prematurity (<37 weeks) has been associated with PROM in 30% of cases, and in turn, PROM has been associated with C. trachomatis infection in 6‐7% of pregnant women 6,7,56,57 .…”

Section: Discussionmentioning

confidence: 99%

“…The role of this bacterial species in miscarriage is still controversial. 54,55 In large population-based studies, prematurity (<37 weeks) has been associated with PROM in 30% of cases, and in turn, PROM has been associated with C. trachomatis infection in 6-7% of pregnant women. 6,7,56,57 In a previous study based on screening during labour (Gipuzkoa, 2011-2014), we found PROM in 7.6% of women with C. trachomatis infection.…”

Section: Clinical Characteristicsmentioning

confidence: 99%

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Prevalence of Chlamydia trachomatis, Mycoplasma genitalium, and Neisseria gonorrhoeae infections in a screening program for under‐30‐year‐old pregnant women with a high participation rate in northern Spain (2016–2020)

Piñeiro

Zubikarai

Manzanal

et al. 2022

Repro Female Child Health

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To assess a screening program for sexually transmitted infections (STIs) in under-30-year-old pregnant women, focusing on Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections, which though often asymptomatic, may significantly affect women's health and can be vertically transmitted. Design: Prospective, descriptive, observational study. Setting: Gipuzkoa (Basque Country, Spain). Population: Under-30-year-old pregnant women. Methods: Between 2016 and 2020, cervical samples were taken at first prenatal appointments from 3051 women. STIs were detected by multiplex nucleic acid amplification. Main Outcome Measures: Prevalence of infections by age and geographical origin groups, and screening coverage. Results: The coverage rate was 86% between 2017 and 2020. At least one STI was detected in 5.2% of the under-30-year-olds screened (95% confidence interval [CI]: 4.5%, 6.1%): C. trachomatis in 4%, M. genitalium in 1.3% and N. gonorrhoeae in 0.1%. C. trachomatis and M. genitalium prevalence rates were higher among younger women (7.2% and 2.8%, respectively in under-25-year-olds), while C. trachomatis prevalence in 25-to 30-year-olds was 2.5%. C. trachomatis was more common among Latin American women (9.7% [95% CI: 7.4%, 12.3%] vs. 2.5% [95% CI: 2.0%, 3.2%] in other women). Additionally, analysing samples from 708 pregnant over-30-year-old women with STI risk factors, 1.6% had at least one of the STIs studied. Notably, 20% of all cases had STI-related symptoms or complications during pregnancy. Conclusions: The high coverage achieved, and prevalence, clinical and epidemiological results support the view that the implementation of a screening program across Spain for C. trachomatis in under-30-year-old pregnant women would be both feasible and appropriate.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Characteristicsmentioning

confidence: 99%

Prevalence of Chlamydia trachomatis, Mycoplasma genitalium, and Neisseria gonorrhoeae infections in a screening program for under‐30‐year‐old pregnant women with a high participation rate in northern Spain (2016–2020)

Piñeiro

Zubikarai

Manzanal

et al. 2022

Repro Female Child Health

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“…Although sensitive to antibiotics, their therapeutic benefit is limited mainly because of silent (asymptomatic) and recurrent infections attributable to immune evasion and the development of partial immunity from these infections. In the long term, these recurrent infections are thought to be contributing to the development of pelvic inflammatory disease ( 4 ), tubal infertility ( 5 ), cervical cancer ( 6 ), adverse pregnancy, miscarriage ( 7 ) in women, urethritis, epididymitis, orchitis, prostatitis, proctitis ( 8 ) or reactive arthritis ( 9 ) in men. These outcomes are thought to be culminating either alone or as a complex combination of Chlamydial pathogenesis, deficient or inferior immunological memory- immune escape and immunopathology.…”

Section: Introductionmentioning

confidence: 99%

Insights into innate immune cell evasion by Chlamydia trachomatis

Wang,

Wu,

Fang

et al. 2024

Front. Immunol.

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Chlamydia trachomatis, is a kind of obligate intracellular pathogen. The removal of C. trachomatis relies primarily on specific cellular immunity. It is currently considered that CD4+ Th1 cytokine responses are the major protective immunity against C. trachomatis infection and reinfection rather than CD8+ T cells. The non-specific immunity (innate immunity) also plays an important role in the infection process. To survive inside the cells, the first process that C. trachomatis faces is the innate immune response. As the “sentry” of the body, mast cells attempt to engulf and remove C. trachomatis. Dendritic cells present antigen of C. trachomatis to the “commanders” (T cells) through MHC-I and MHC-II. IFN-γ produced by activated T cells and natural killer cells (NK) further activates macrophages. They form the body’s “combat troops” and produce immunity against C. trachomatis in the tissues and blood. In addition, the role of eosinophils, basophils, innate lymphoid cells (ILCs), natural killer T (NKT) cells, γδT cells and B-1 cells should not be underestimated in the infection of C. trachomatis. The protective role of innate immunity is insufficient, and sexually transmitted diseases (STDs) caused by C. trachomatis infections tend to be insidious and recalcitrant. As a consequence, C. trachomatis has developed a unique evasion mechanism that triggers inflammatory immunopathology and acts as a bridge to protective to pathological adaptive immunity. This review focuses on the recent advances in how C. trachomatis evades various innate immune cells, which contributes to vaccine development and our understanding of the pathophysiologic consequences of C. trachomatis infection.

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“…Past chlamydia infections increase the risk of infertility and ectopic pregnancy, but the association with miscarriage is equivocal (seeHorne et al, 2020).…”

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confidence: 99%

Teenage mothers and the next generation: benefits of delay?

2023

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This paper investigates whether delaying motherhood beyond the teenage years benefits children. We account for selection into teenage motherhood in two parallel ways: We compare children with their cousins and we exploit miscarriages as a natural experiment that induces some women to postpone childbirth. Across the two strategies, we find no or limited effects of teenage motherhood on children’s health and educational outcomes. When we use women delaying motherhood to their early twenties as a counterfactual for teenage mothers, we show suggestive evidence that the effects of such delays are nil across outcomes for both strategies.

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Association of Past Chlamydia trachomatis Infection With Miscarriage

Cited by 6 publications

References 5 publications

Prevalence of Chlamydia trachomatis, Mycoplasma genitalium, and Neisseria gonorrhoeae infections in a screening program for under‐30‐year‐old pregnant women with a high participation rate in northern Spain (2016–2020)

Prevalence of Chlamydia trachomatis, Mycoplasma genitalium, and Neisseria gonorrhoeae infections in a screening program for under‐30‐year‐old pregnant women with a high participation rate in northern Spain (2016–2020)

Insights into innate immune cell evasion by Chlamydia trachomatis

Teenage mothers and the next generation: benefits of delay?

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