Chlamydia trachomatis and Adverse Pregnancy Outcomes: Meta-analysis of Patients With and Without Infection

Abstract

This review provides evidence that chlamydia in pregnancy is associated with a small increase in the odds of multiple adverse pregnancy outcomes. The literature is complicated by heterogeneity and the fact that the association may not hold in higher quality and prospective studies or those that use more contemporary nucleic acid testing.

Infecção do trato genital inferior por Chlamydia trachomatis em gestantes de um estudo aninhado a coorte BRISA

“…In contrast with our findings, Liu et al noted a causative association among women with a prior CT diagnosis and sPTB (aOR 1.17, 95% CI 1.01 -1.37) (10). Also, in a recent meta-analysis of Olson-Chen et al, CT during pregnancy was associated with PTB (OR 1.27, 95%CI 1.05 -1.54) (25). Nevertheless, we noticed that the lower limit of the Confidence Interval in these studies is close to 1, which means that it is close to the lack of significance, so this result may be attributed to the sample size.…”

Risk Factors for <i>Chlamydia trachomatis</i> Infection and Preterm Birth in Pregnant Japanese Women: Does Chlamydial Infection Cause Preterm Birth?

“…prior studies have reached differing conclusions. According to a metaanalysis by Olson-Chen et al(11), chlamydial infection during pregnancy was associated with preterm birth. However, this association weakened when the analysis was limited to highquality studies.…”

Chlamydia trachomatis and reproductive health: what can we learn from systematic reviews of observational studies?

“…The systematic review by Tang et al does not allow a precise quantification of the causal association between CT infection and the multiple potential adverse outcomes for women’s reproductive health. Their findings will, however, be relevant to the interpretation of systematic reviews of associations between other sexually transmitted and genital tract infections and pregnancy outcomes 8 12 13. The review also highlights methodological issues that researchers can take into account for future studies.…”

“…In an earlier systematic review, Olson-Chen et al examined eight adverse outcomes of pregnancy, but not fertility, and included 56 studies published between 1970 and 2013,8 with some overlap in outcomes and included studies with Tang et al . In both reviews, the strength of association was smaller in studies judged to be of better methodological quality 6 8. In neither review, however, did the authors identify which specific biases were associated with attenuation in the effect size.…”