Spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy.

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Pediatrics; Obstetrics & Gynecology
Creator Varner, Michael W.
Other Author Sheffield, Jeanne S.; Andrews, Williams W.; Klebanoff, Mark A.; Macpherson, Cora; Carey, J. Christopher; Ernest, J. M.; Wapner, Ronald J.; Trout, Wayne; Moawad, Atef; Miodovnik, Menachem; Sibai, Baha; Caritis, Steve N.; Dombrowski, Mitchell; Langer, Oded; O'Sullivan, Mary J.; National Institute for Child Health and Human Development Maternal-Fetal Medicine Units Network.
Title Spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy.
Date 2005-03
Description OBJECTIVE: We sought to estimate the rate of spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy and to evaluate factors associated with its resolution. METHODS: A cohort of women enrolled in a large multicenter randomized bacterial vaginosis antibiotic trial (metronidazole versus placebo) that, when randomly allocated, had asymptomatic C trachomatis diagnosed by urine ligase chain reaction (from frozen archival specimens) between 16(0/7) and 23(6/7) weeks were included. The urine ligase chain reaction is a highly accurate predictor of genital tract chlamydial infection. A follow-up ligase chain reaction was performed between 24(0/7) and 29(6/7) weeks. RESULTS: A total of 1,953 women were enrolled in the original antibiotic trial; 1,547 (79%) had ligase chain reaction performed both at randomization and follow-up. Women receiving antibiotics effective against Chlamydia between randomization and follow-up or having symptomatic Chlamydia infection were excluded (26 women). Of the 140 women (9%) who were diagnosed as positive via the initial ligase chain reaction assay, 61 (44%) had spontaneous resolution of Chlamydia by the follow-up ligase chain reaction assay. Factors associated with spontaneous resolution included older age (P = .02), more than 5 weeks from randomization to follow-up (P = .02), and a greater number of lifetime sexual partners (P = .02). Using a logistic regression model, maternal age and a greater-than-5-week follow-up interval remained significant; for every 5-year increase in maternal age, the odds of a positive result on the ligase chain reaction test at follow-up decreased by 40% (odds ratio 0.6; 95% confidence interval 0.4-0.9). Race, substance abuse, parity, and treatment with metronidazole were not associated with spontaneous resolution. Gram stain score and vaginal pH at randomization and follow-up also were not associated. CONCLUSION: The prevalence of asymptomatic C trachomatis in pregnancy was 9%; infection resolved spontaneously in almost half of these women. The association of older age and increasing time interval to spontaneous resolution of Chlamydia is consistent with a host immune-response mechanism.
Type Text
Publisher Lippincott, Williams & Wilkins
Volume 105
Issue 3
First Page 557
Last Page 562
Subject Pregnancy; Chlamydia Trachomatis; Sexually Transmitted Diseases
Subject MESH Chlamydia trachomatis; Pregnancy Complications; Ligase Chain Reaction
Language eng
Bibliographic Citation Sheffield JS, Andrews WW, Klebanoff MA, Macpherson C, Carey JC, Ernest JM, Wapner RJ, Trout W, Moawad A, Miodovnik M, Sibai B, Varner MW, Caritis SN, Dombrowski M, Langer O, O'Sullivan MJ; National Institute for Child Health and Human Development Maternal-Fetal Medicine Units Network. Spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy. Obstet Gynecol. 2005 Mar;105(3):557-62. Retrieved on April 20, 2007 from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=Display&DB=pubmed
Rights Management Copyright © Wolters Kluwer, Obstetrics and Gynecology, 105, 557-62, 2005
Format Medium application/pdf
Identifier ir-main,957
ARK ark:/87278/s61z4nxz
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 705881
Reference URL https://collections.lib.utah.edu/ark:/87278/s61z4nxz
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