Blas Magaly M, Canchihuaman Fredy A, Alva Isaac E, Hawes Stephen E
Department of Epidemiology,School of Public Health and Community Medicine, University of Washington, Seattle, WA 98103, USA.
Sex Transm Infect. 2007 Jul;83(4):314-8. doi: 10.1136/sti.2006.022665. Epub 2007 Mar 7.
To measure the risk of preterm delivery, premature rupture of membranes, infant low birth weight and infant mortality, by a population-based retrospective cohort study using Washington State birth certificate data.
All women diagnosed with Chlamydia trachomatis infection (n = 851), noted with a check box on the birth certificate from 2003, and a randomly selected sample of women not diagnosed with C trachomatis (n = 3404) were identified. To assess the RR between chlamydia infection and pregnancy outcomes, multivariable logistic regression analysis was used.
Women with chlamydia infection were younger, more likely to be non-white and had less years of education compared with women without chlamydia. Additionally, they were more likely to have inadequate prenatal care and coinfections with other sexually transmitted infections. After adjusting for age and education, chlamydia-infected women were at an increased risk of preterm delivery (RR 1.46, 95% CI 1.08 to 1.99) and premature rupture of membranes (RR 1.50, 95% CI 1.03 to 2.17) compared with non-infected women. However, no increased risk of infant death (RR 1.02, 95% CI 0.37 to 2.80) or low birth weight (RR 1.12, 95% CI 0.74 to 1.68) associated with chlamydia infection was observed.
This study suggests that C trachomatis is associated with an increased risk of preterm delivery and premature rupture of membranes, but not with infant death and low birth weight. Routine screening and opportune treatment for C trachomatis should be considered a necessary part of prenatal care to reduce these adverse pregnancy outcomes.
通过一项基于人群的回顾性队列研究，利用华盛顿州出生证明数据来衡量早产、胎膜早破、婴儿低出生体重和婴儿死亡率的风险。
确定所有被诊断为沙眼衣原体感染的女性（n = 851），这些女性在2003年的出生证明上通过复选框被记录，以及一个未被诊断为沙眼衣原体感染的女性随机样本（n = 3404）。为了评估衣原体感染与妊娠结局之间的相对危险度（RR），采用多变量逻辑回归分析。
与未感染衣原体的女性相比，感染衣原体的女性更年轻，更可能是非白人，且受教育年限更少。此外，她们更可能没有充分的产前护理，并且与其他性传播感染合并感染。在调整年龄和教育因素后，与未感染的女性相比，感染衣原体的女性早产风险增加（RR 1.46，95%可信区间1.08至1.99）和胎膜早破风险增加（RR 1.50，95%可信区间1.03至2.17）。然而，未观察到与衣原体感染相关的婴儿死亡风险增加（RR 1.02，95%可信区间0.37至2.80）或低出生体重风险增加（RR 1.12，95%可信区间0.74至1.68）。
本研究表明，沙眼衣原体与早产和胎膜早破风险增加相关，但与婴儿死亡和低出生体重无关。对沙眼衣原体进行常规筛查和适时治疗应被视为产前护理的必要组成部分，以减少这些不良妊娠结局。
