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Perinatally acquired Chlamydia trachomatis associated morbidity in young infants
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA. sjain@emory.edu
Insights
Perinatal Chlamydia trachomatis infection causes significant illness in infants, including conjunctivitis and pneumonia. Improved maternal screening and treatment are crucial to prevent infant infections.
Area of Science:
- Neonatal infections
- Pediatric infectious diseases
- Public health and epidemiology
Background:
- Perinatal Chlamydia trachomatis infection is a significant concern in neonatal health.
- Infants are at risk of developing serious complications from untreated maternal infections.
Purpose of the Study:
- To evaluate the spectrum of morbidity in infants under 12 weeks old with perinatally acquired Chlamydia trachomatis.
- To determine the relationship between infant infection and maternal Chlamydia trachomatis status.
Main Methods:
- Retrospective review of maternal and infant medical records.
- Analysis of symptomatic infants tested for Chlamydia trachomatis in the upper respiratory tract.
- Inclusion of 530 infants seen over a 2-year period at a large inner-city teaching hospital.
Main Results:
- 13.2% of infants tested positive for Chlamydia trachomatis.
- Common morbidities included conjunctivitis (73%) and pneumonia (20%).
- Maternal records revealed inadequate screening and treatment in a significant number of cases.
Conclusions:
- Perinatal Chlamydia trachomatis infection is associated with substantial infant morbidity.
- There is a critical need for enhanced maternal Chlamydia trachomatis testing and treatment protocols to reduce perinatal transmission.
Objective:
This study was designed to evaluate the spectrum of morbidity associated with perinatally acquired Chlamydia trachomatis in infants < or =12 weeks of age, and to determine its relationship to maternal Chlamydia trachomatis status.
Design:
Retrospective review of maternal and infant records.
Setting:
Large inner city teaching hospital.
Patients:
A cohort of 530 symptomatic infants < or =12 weeks of age who were tested for Chlamydia trachomatis infection in the upper respiratory tract during a 2-year period from January 1993 to December 1994.
Results:
During the study period, 70/530 (13.2%) patients tested positive for Chlamydia trachomatis from the conjunctiva and/or the nasopharynx. Complete medical records of 66 of these infants were available for review. Forty-eight of 66 (73%) infants had conjunctivitis, 13/66 (20%) had pneumonia, 5/66 (7%) had both conjunctivitis and pneumonia. Thirteen of 66 (20%) infants were hospitalized, 7 for pneumonia and 6 for ophthalmia, accounting for 68 hospital days. In 55/66 (83%), maternal records were available for review. Nineteen of 55 (35%) mothers had documented Chlamydia trachomatis infection at delivery or during pregnancy that had not been treated; 16/55 (29%) mothers tested negative for Chlamydia trachomatis sometime during pregnancy but were not retested at delivery, 8/55 (14%) were treated for Chlamydia trachomatis during pregnancy but status at delivery regarding reinfection was not evaluated. In 12/55 (22%) mothers, no prenatal testing was documented.
Conclusions:
This study demonstrates significant morbidity in early infancy associated with perinatally acquired Chlamydia trachomatis infection. There is need for studies evaluating the importance of adequate maternal testing and treatment to reduce perinatal transmission.