Chlamydial infections in pregnancy.

Chlamydia trachomatis is recognized as a common sexually transmitted cervical pathogen that may be transmitted to the neonate at delivery. Neonatal infection may be manifested as conjunctivitis, pneumonitis or both. Additionally, cervical infection may be related to premature rupture of the membranes and premature delivery. Women registering for prenatal care in the first half of pregnancy were cultured for Chlamydia to further define its role as a cause of perinatal complications and to evaluate a method of preventing transmission to the neonate. Positive cultures were obtained in 33 of 221 women evaluated (14.9%). No significant differences were found in pregnancy or neonatal complications between the groups with positive and negative cultures. Women with positive cultures were treated at 36 weeks' gestation with erythromycin; 18 received an adequate course of therapy. Of these 18, 16 returned with their infants four to eight weeks postpartum. No symptoms of conjunctivitis or pneumonitis were noted at that time, and cultures of the conjunctiva and nasopharynx were negative in all the infants. Thus, surveillance for Chlamydia and treatment late in pregnancy appear to have no adverse impact on pregnancy and effectively block vertical transmission of the organism.