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Background: In pregnant women, untreated Chlamydia trachomatis (C.tr) infections are associated with abortions, premature rupture of membranes, postpartum endometritis, low birth weight and transmission to the newborn. The risk of infection in a newborn from infected mother is about 50% and can cause bronchitis, pneumonia and neonatal conjunctivitis. In our country there are no data about C.tr infection in pregnant women. Due to this, three topics are important: to study the prevalence, to establish a risk group and to determine genetic characteristics of this microorganism in this population.
Methods: An amount of 509 cervical swabs were collected, with an informed consent, from pregnant women between September 2013 and February 2014. Of the total, 301 belonged to low-income women and the remaining 208 were pregnant with high socioeconomic status. We used the following primers for molecular diagnosis: NLO/NRO directed against MOMP and CTP1/CTP2 for C.tr cryptic plasmid. Positive samples were sequenced and analyzed phylogenetically. Descriptive statistical simply analysis was performed.
Results: We obtained a 6.9% (95% CI: 4.9%, 9.5%) prevalence of C.tr infection with rates of 11.6% (30/258) in women under 25 years old, compared with 2% (5/251) in patients over that age (p<0.01). It was evident that the low-income pregnant have an increased risk of infection (91.4% vs. 8.6% p<0.01). We found the following genotypes: B=2.9%(n=1); D=14.2%(n=5); E=40%(n=14); F=22.8%(n=8); G=5.7%(n=2); Ia=2.9%(n=1) and L2=8.6%(n=3). In the phylogenetic analysis our sequences group with worldwide counterparts.
Conclusions: The pregnant patients under 25 years with low socioeconomic status are a group at high risk for C.tr infection. Knowing the consequences of this infection, and that the most effective way to prevent complications is early diagnosis and treatment of pregnant women; it would be necessary to include the diagnosis of C.tr in the screening programs of this risk group.