Correlation of Intrapartum Chlamydia trachomatis Infection with Obstetric and Perinatal Outcome

Chlamydia trachomatis is the most common bacterial sexually transmitted infection worldwide, often asymptomatic but associated with adverse maternal and perinatal outcomes. Limited data are available from India regarding intrapartum infection and its clinical implications.

The aim is to determine the prevalence of intrapartum C. trachomatis infection and its correlation with obstetric and perinatal outcomes.

This prospective observational study included 147 pregnant women admitted for delivery at a tertiary care center. Endocervical swabs were collected intrapartum and tested for C. trachomatis using polymerase chain reaction. Maternal and neonatal outcomes, including gestational age at delivery, puerperal sepsis, early-onset neonatal sepsis (EOS), low birth weight (LBW), neonatal intensive care unit (NICU) admission, stillbirth, and neonatal death, were recorded. Statistical analysis was performed using SPSS version 25.0, with P < 0.05 considered statistically significant.

The prevalence of intrapartum C. trachomatis infection was 19.7% (29/147). Preterm delivery was significantly higher among infected women (27.6% vs. 11.9%, P = 0.04). Puerperal sepsis occurred in 17.2% of infected women compared to 3.4% of uninfected women (P = 0.01). EOS was observed in 20.7% of neonates born to infected mothers versus 6.8% of those born to uninfected mothers (P = 0.02). LBW was more frequent among neonates of infected mothers (31.0% vs. 12.7%, P = 0.03) and NICU admissions were also significantly higher (24.1% vs. 10.2%, P = 0.04). Although stillbirth (6.9% vs. 1.7%) and neonatal death (3.4% vs. 0.8%) were more common in the positive group, these were not statistically significant.

Intrapartum C. trachomatis infection is common and significantly associated with preterm birth, puerperal sepsis, neonatal sepsis, LBW, and increased NICU admissions. Routine antenatal screening and timely treatment could substantially improve maternal and perinatal outcomes.