Effect of Chlamydia trachomatis on adverse pregnancy outcomes: a meta-analysis

Purpose To analyze the effect of Chlamydia trachomatis ( C. trachomatis ) on adverse pregnancy outcomes based on the currently available evidence. Methods Multiple databases were comprehensively searched from the available date of inception through December 9, 2019. The effect of C. trachomatis on adverse pregnancy outcomes was assessed using pooled odds rations (ORs) and 95% confidence intervals (CIs). Egger’s test was used for publication bias. Results Fifty studies involving 502,141 participants were identified. C. trachomatis infection was found to be associated with preterm birth in antibody detection [OR (95% CI): 1.571 (1.112–2.220), P = 0.010] and high-quality assessment [OR (95% CI): 1.734 (1.295–2.321), P < 0.001], preterm premature rupture of membranes (PPROM) in culture detection [OR (95% CI): 4.339 (1.806–10.424), P = 0.001] and high-quality assessment [OR (95% CI): 2.822 (1.333–5.973), P = 0.007], stillbirth [OR (95% CI): 1.585 (1.219–2.062), P = 0.001], low-birthweight babies [OR (95% CI): 2.205 (1.137–4.274), P = 0.019], and babies small for gestational age [OR (95% CI): 1.193 (1.091–1.305), P < 0.001]. No publication bias was exhibited in miscarriage ( P = 0.170), preterm birth ( P = 0.303), PPROM ( P = 0.341), stillbirth ( P = 0.533), and low-birthweight babies ( P = 0.535). Conclusions C. trachomatis infection during pregnancy is associated with a higher risk of preterm birth, PPROM, stillbirth, low-birthweight babies, and babies small for gestational age.