Carriage of Chlamydia trachomatis during pregnancy: consequences for mother and infant

Abstract

Rates of transmission of Chlamydia trachomatis infection from apparently healthy, black, pregnant South African women to their newborns were studied in a setting where tetracycline eye prophylaxis is routinely provided to prevent neonatal conjunctivitis. The postnatal consequences of maternal chlamydial carriage during pregnancy were also evaluated for both mother and child. A total of 77 chlamydia-positive women and their newborns were followed-up. The chlamydial transmission rate from mother to infant was estimated to be 30%. C. trachomatis was detected in the conjunctivae of 39% and in the nasopharynx of 83% of these infants. Tetracycline eye prophylaxis appeared to prevent overt ocular, but not nasopharyngeal infection. Postnatal genitourinary symptoms and signs were found in 52% and 78% of chlamydia-positive mothers respectively with 18% developing post-partum pelvic inflammatory disease. The complex of postnatal maternal genitourinary symptoms and signs in combination with symptoms and signs in the infant, should alert clinicians to the possibility of neonatal and maternal complications of chlamydial infection.