The prevalence of Chlamydia trachomatis in the cervix of puerperal women, and its consequences for the outcome of pregnancy

During a five-month period all puerperal women at the Department of Obstetrics, University Hospital of Trondheim, Norway, were screened for Chlamydia trachomatis (C. trachomatis) from the cervix uteri on the 4-6th day postpartum. Outcomes of the pregnancies were examined. The prevalence of C. trachomatis in the total population of 599 eligible women was 5.8% (35:599), while 3.0% (18:599) of the cultures were inconclusive. The prevalence of C. trachomatis in women aged less than 20 years was 25.8%; aged 20-24 years, 8.9% and greater than 24 years, 2.3%. The prevalence of C. trachomatis among women living alone was 17.2%; among women in cohabitation, 9.2% and among married women, 3.2%. There was no relationship between the presence of C. trachomatis and preterm birth, birth weight and birth weight for gestation, stillbirth or neonatal death. During the first fourteen postpartum days no puerperal infections were seen among chlamydia-positive mothers. The chlamydia-positive women and their partners were then treated with erythromycin stearat 1,000 mg daily for 12 days. Samples for cervix 14 days after completion of the treatment were chlamydia-negative for all 35 women. Screening all pregnant women under the age of 25 years would detect 80% of the pregnant population harbouring C. trachomatis in the cervix uteri. Based on findings from this study and from cost-benefit analyses, we recommend screening of all pregnant women under the age of 25 years in our attachment area.