Chlamydia trachomatis Infection in Pregnancy: The Global Challenge of Preventing Adverse Pregnancy and Infant Outcomes in Sub-Saharan Africa and Asia

Table 3

Studies from sub-Saharan Africa and Asia on Chlamydia trachomatis screening and treatment in pregnancy to prevent adverse pregnancy and infant outcomes.

CT screening/treatment to prevent adverse pregnancy and infant outcomes (total studies = 2)
CT screening/treatment to prevent adverse pregnancy outcomes (studies = 2)
Study	Region	Country	Support benefit	Findings
Gray et al.,; 2001 [26]	Africa	Rakai, Uganda	Yes	Evaluated 2070 pregnant women in an analysis from a cluster-randomized STI presumptive treatment trial with azithromycin, cefixime, and metronidazole (also included benzathine penicillin G if syphilis serology was positive) versus placebo. Found reduction in CT/NG (RR 0.43, 95% CI 0.27–0.68) and other STIs. Found reduction in low birth weight (RR 0.68, 95% CI 0.53–0.86), preterm delivery (RR 0.77, 95% CI 0.56–1.05), neonatal death, (RR 0.83, 95% CI 0.71–0.97), and infant ophthalmia (RR 0.37, 95% CI 0.20–0.70).
Rastogi et al.,; 2003 [39]	Asia	New Delhi, India	Yes	Erythromycin was given to 17 CT-infected pregnant women and compared to 42 untreated CT-infected women lost to follow-up and 269 women without CT. CT-infected and treated women had infants with higher mean gestational ages at the time of delivery (35.5 versus 33.1 weeks, < 0.05) and higher birth weights (2200 versus 2113.3 g, although not significant) in comparison to untreated women. Stillbirths were higher in CT-infected and untreated women in comparison to the CT-uninfected (11.5% versus 4.7%), and 0% in CT-infected treated women.
CT screening/treatment to prevent adverse infant outcomes (studies = 0)
None

Study by Gray et al. [26] includes some adverse infant outcomes—neonatal death and infant ophthalmia as noted above.
CT = Chlamydia trachomatis, NG = Neisseria gonorrhoeae, STI = sexually transmitted infection.