Chlamydia trachomatis screening in preterm labor: A systematic review and meta-analysis

Area of Science:

• Obstetrics and Gynecology
• Infectious Diseases
• Reproductive Health

Background:

• Spontaneous preterm labor (PTL) contributes to nearly half of all preterm births.
• Intrauterine infections are a significant risk factor for PTL.
• Chlamydia trachomatis has been linked to preterm birth and prelabor rupture of membranes, but its specific role in PTL requires clarification.

Purpose of the Study:

• To determine the prevalence of Chlamydia trachomatis infections in pregnant women experiencing threatened PTL.
• To compare this prevalence to that in pregnant women not experiencing threatened PTL.

Main Methods:

• A systematic literature search was conducted using keywords related to Chlamydia, vaginal/cervical infections, and preterm labor.
• Included were cohort and case-controlled studies that diagnosed threatened PTL and Chlamydia trachomatis via culture or NAAT.
• Meta-analysis utilized a random effects model, with bias assessed using the MINORS score and reporting guided by MOOSE guidelines.

Main Results:

• Four studies involving 591 women (309 with threatened PTL, 282 controls) were analyzed.
• The prevalence of Chlamydia trachomatis in women with threatened PTL was 9% (27/308) compared to 1% (3/282) in controls.
• Women in threatened PTL had a significantly increased risk of Chlamydia trachomatis infection (OR 7.74, 95% CI 2.64-22.71).

Conclusions:

• The incidence of Chlamydia trachomatis in women with threatened PTL is approximately 9%, which is significantly higher than in asymptomatic controls.
• These findings suggest Chlamydia trachomatis is an important factor in threatened preterm labor.
• Screening for Chlamydia trachomatis should be considered in pregnant women presenting with threatened PTL.