Maternal and infant chlamydia trachomatis infections

Chlamydia trachomatis infections in pregnancy present several challenges. In addition to potentially affecting the pregnancy, the infection may also affect the developing fetus and be transmitted to the infant during parturition. C. trachomatis infection during pregnancy has been associated with a number of adverse outcomes including stillbirth, low birth weight and premature delivery. Data on the effect of treatment of maternal infection on outcome of pregnancy have been inconclusive. C. trachomatis infection has also been associated with postpartum endometritis and postabortal pelvic inflammatory disease. The risk of an infant born to an infected mother of acquiring C. trachomatis infection is approximately 50%. The infant may become infected at multiple sites including the conjunctivae, nasopharynx, rectum and vagina. The most common clinical manifestation is neonatal conjunctivitis. Although the nasopharynx is the most frequent site of infection in infants, most of these infections are asymptomatic and may persist for months. Approximately 25% of infants with nasopharyngeal infection may develop a characteristic pneumonia, usually 1-3 months after birth. The most effective approach to preventing perinatal chlamydial infection is screening and treatment of pregnant women. This has been greatly facilitated by the use of nucleic acid amplification tests for diagnosis and the availability of effective single-dose antibiotic treatment.

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