Identifying the impact of Chlamydia trachomatis screening and treatment on mother-to child transmission and respiratory neonatal outcomes in Mexico

Abstract

Abstract Unfavorable pregnancy outcomes caused by Chlamydia trachomatis (C. trachomatis), such as premature rupture of membranes, preterm birth, and low birth weight, are well known. Mother-to-child transmission can occur at the time of birth and may result in conjunctivitis and pneumonia in the newborn. We therefore evaluated to question whether just one maternal screening for Chlamydia is enough to prevent adverse pregnancy and negative neonatal outcomes. Among the 4,087 first-time gynecological-obstetric consultations granted at the National Institute of Perinatology in 2018, we selected the study population according to a case-cohort design. Antenatal Chlamydia screening and treatment interventions were performed on 628 pregnant women using COBAS® TaqMan CT. Chlamydia DNA was also detected in samples from 157 infants of these mothers. We find that C. trachomatis positivity was detected in 10.5%. The vertical transmission rates were 1.5% for thecohort of mothers with a Chlamydia-positive test and 29.7% for those with a negative test. By evaluating symptomatic neonatal infection, the hazard rate of perinatal pneumonia was 3.6 times higher in Chlamydia-positive babies than in Chlamydia-negative babies. Despite the low rate of mother-to-child transmission in women positive for Chlamydia trachomatisdetected with a nucleic acid amplification test and who received timely treatment, possible maternal reinfectionthat is not detected during pregnancy significantly increases the risk of neonatal infection with consequent perinatal pneumonia.