Comparison of pregnancy outcome between treated and untreated women with chlamydial cervicitis

Maternal, fetal, neonatal, and infant outcome in treated versus untreated pregnant women with positive endocervical cultures for Chlamydia trachomatis is controversial.

One thousand three hundred fifty pregnant women registering consecutively on the staff clinic service were screened for chlamydia. The results of the antigen, but not the culture tests, were available for clinical management.

Eighty one patients had positive chlamydia cultures, a prevalence rate of 5.1%. Fifty eight patients were not treated, 44 because of false-negative direct antigen tests. Twenty three patients were treated. Maternal complications including abortion, preterm rupture of membranes, preterm delivery, chorioamnionitis, and endometritis were similar in the two groups. Similarly, neonatal and infant complications including prematurity, conjunctivitis, and pneumonia were similar in the two groups.

Our findings suggest that further prospective, controlled culture based studies are needed before recommending routine screening for chlamydia even in high risk populations.