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Background: Pregnant women are vulnerable to complications from Chlamydia trachomatis (CT) infections. Limited information exists regarding Chlamydia epidemiology among this group. CT positivity among non-pregnant women is associated with younger age, racial/ethnic minority status, and previous CT infection.
Objectives: To identify risk factors for CT positivity among pregnant women.
Methods: We examined Region X Infertility Prevention Project (IPP) data for pregnant women aged 15–24 years attending family planning (FP) clinics, 2003–2006. Clinics used a common data form capturing client demographics, pregnancy status, sexual risk behaviors, and clinical findings. Odds ratios for risk factors were identified by multivariable logistic regression.
Results: Of 27,926 CT tests performed, 59.0% were among women aged 20–24 years, 39.9% among racial/ethnic minorities, and 10.4% among women with one or more behavioral risk factors; 68.6% were screened with nucleic-acid amplification technology (NAAT) tests. Overall, CT positivity was 6.9%. Risk factors for CT positivity were age 15–17 years (reference group: age 20–24 years) (adjusted odds ratio [aOR] = 1.40; 95% confidence interval [CI], 1.23–1.60), racial/ethnic minority (aOR = 1.31; 95% CI, 1.19–1.45), one or more behavioral risk factors (aOR = 1.59; 95% CI, 1.38–1.83), known exposure to CT (aOR = 3.62; 95% CI, 2.46–5.33), one or more related clinical findings (aOR = 2.93; 95% CI, 2.49–3.45), testing by NAAT (aOR = 1.31; 95% CI, 1.16–1.48), and positive CT test during previous year (aOR = 1.73; 95% CI, 1.42–2.12).
Conclusions: FP clinics screen significant numbers of young pregnant women. CT positivity is substantial in this clinic population. Rates of CT positivity and risk factors for CT are similar among young pregnant and non-pregnant women.
Implications for Programs, Policy, and/or Research: These data support the need for routine prenatal CT screening. Testing and counseling services among pregnant clients and those presenting to FP clinics should remain a program priority.