Introduction
Screening and treatment of sexually transmitted infections (STIs) in
pregnancy represents an overlooked opportunity to improve maternal and
perinatal outcomes worldwide (1). Although Chlamydia trachomatis
(CT) is the most commonly treatable bacterial STI, few countries have
routine pregnancy screening and treatment programs for CTinfections in pregnancy (2-4). CT infections in women usually would go
undiagnosed since the infections are mostly asymptomatic and poses
serious challenges to the management of the disease (4). The majority of
infected individuals would report for care in the advanced stage or may
report with complications since the infection remain asymptomatic for a
long time (5-7)
CT infection has been implicated in several adverse obstetric outcomes;
premature rapture of membrane, amnionitis, intrapartum fever, and
meconium stained amniotic fluid (8, 9). These adverse pregnancy outcomes
have been identified to be associated with neonatal sepsis (10).
Similarly, adverse neonatal outcomes that were known to be associated
with vertical transmission have also been reported by previous studies
as preterm delivery, low birth weight and Apgar score less than 7 at
minutes one and five (3, 10, 11). Spontaneous abortion and stillbirth
have also been reported to be significantly associated with CT infection
(11).
Vertical transmission of diseases occurs at one of these stages: in
utero, intrapartum and postpartum. The severity of morbidity and
mortality of most vertically transmitted diseases would depend on the
gestational age at which the infection was acquired (12). Though
vertical transmission of CT has been widely reported, there is paucity
of literature on the gestational age at which the infections were
transmitted to the fetus or the neonate. The impact of the various
routes of transmission on the neonate is not well defined. The aim of
the present study is to determine the relationship between
trans-placental transmission of CT infection in pregnancy and survival
at birth of the fetus.