Impact of Chlamydia on pregnancy and fertility-related outcomes

Takeaway

• Chlamydia trachomatis was associated with an increased risk for several pregnancy and fertility-related adverse outcomes.

Why this matters

• Chlamydia trachomatis is the most common bacterial sexually transmitted infection in the world.
• Limited studies have confirmed the relationship between chlamydia infection and pregnancy and fertility-related adverse outcomes.

Study design

• The meta-analysis of 107 studies reporting pregnancy and fertility outcomes associated with chlamydia infection.
• Funding: National Institutes of Health.

Key results

• Chlamydia infection was positively associated with pregnancy and fertility-related adverse outcomes, including:
  • stillbirth (OR, 5.05; 95% CI, 2.95-8.65 for case-control studies and risk ratio [RR], 1.28; 95% CI, 1.09-1.51 for cohort studies) and
  • spontaneous abortion (OR, 1.30; 95% CI, 1.14-1.49 for case-control studies and RR, 1.47; 95% CI, 1.16-1.85 for cohort studies).
• The risk for chlamydia infection was higher among women with infertility vs those without (pooled OR, 2.72; 95% CI, 2.37-3.12 for case-control studies and RR, 1.84; 95% CI, 1.77-1.90).
• Compared with high-income countries, the risk for adverse outcomes was associated with chlamydia infection is higher in low- and middle-income countries.

Limitations

• Heterogeneity across studies.