Maternal C. trachomatis
infections during pregnancy may cause a variety of perinatal and neonatal complications. Epidemiological data suggested an association between colonization of the genital tract by C. trachomatis
and an increased risk of preterm PROM.[9
may lead to abortion through excessive maternal immunogenic reaction to its heat shock protein 60 antigen. [12
We evaluated the significance of detection of serum antibodies to C. trachomatis
by ELISA at different time of pregnancy for early diagnosis of perinatal complications. [13
] The incidence of perinatal complications was significantly higher in IgG and IgA antibodies-positive pregnant women at 30 weeks of gestational age. This fact also may indicate of maternal acquisition of re- or new chlamydial infection in later part of pregnancy. Intrauterine C. trachomatis
infections acquired near the time of labor was considered to be associated with perinatal complications.
During the last decade there has been increased interest in possible pathogenic role of organisms that colonize the airways of preterm infants and cause disease processes that could be devastating in this age group.[14
] has been studied in the context of the development of bronchopulmonary dysplasia (BPD.) While serological evidence has associated C. trachomatis
with BPD, cultures for C. trachomatis
have failed to confirm these data. [16
] Additionally, C. trachomatis, Mycoplasma hominis
, and CMV have been implicated as etiologic agents for the development of BPD, [1
] which was not supported by other findings.[14
The serovars of C. trachomatis
that we identified from Japanese infants and pregnant women were similar to those reported in other studies from non-trachoma-endemic areas of developed countries and were thought to be mainly urogenital tract-origin. [5
] Similar results were also obtained from the study of adult inclusion conjunctivitis in Japan. [18
] Antigenic variations of C. trachomatis
were found among the strains from nasopharyngeal, conjunctival and endocervical origins.
Erythromycin and clarithromycin were thought to be not toxic for fetuses and effective for the treatment of endocervical infection of C. trachomatis. Some serological variants of C. trachomatis may have different pathogenicity or drug-sensitivity from classic serotypes. Early diagnosis and appropriate treatment of chlamydial infections may reduce perinatal complications. Oral administration of erythromycin or clarithromycin for the treatment of C. trachomatis respiratory tract infection in early neonatal period was also considered to be effective.
Antigen detection of C. trachomatis
from the endocervix by EIA has been utilized widely for the purpose of the screening of chlamydial infections during pregnancy. However, chlamydial antigen was not detected by EIA from any endocervical specimens of mothers at 20 weeks of gestation. These tests are easily performed and less costly but have lower sensitivities than culture or PCR and have low positive predictive values in low prevalence populations such as Japan.[19
Time of onset of respiratory tract symptoms of five infants in the present study was within 2 weeks after birth. One infant was born by cesarean section. Diagnosis of neonatal chlamydial infections was obtained by antigen or DNA detection from nasopharyngeal swabs and by detection of serum IgG and IgM antibodies to C. trachomatis.
Our results as well as other investigators [4
] demonstrate the clinical characteristics of C. trachomatis
respiratory tract infections among infants in early neonatal period. Although the patients tested positive for C. trachomatis
may not always have been associated with obvious symptoms, it has major role in perinatal mortality.[20
] Control programs emphasizing targeted screening, early diagnosis, and effective treatment will have led to an eventual decline in the incidence of perinatal and neonatal chlamydial infections. [21
] Approaches to prevention and treatment of chlamydial infections in pregnant women and infants seem to be necessary, including new antimicrobial interventions and the development of a vaccine strategy.