Role of maternal serum Chlamydia trachomatis IgG antibodies and serum C-reactive protein in preterm labour

Preeti Dubey, Kiran Pandey, Neetu Singh, Ajay Bhagoliwal, Deepti Sharma

Abstract


Background: The objective was to find the role of maternal serum C- reactive protein and Chlamydia trachomatis IgG antibodies as predictors of preterm delivery.

Methods: This prospective study was conducted in UISEMH, Department of Obstetrics and Gynecology, GSVM Medical College, Kanpur from September 2011 to September 2013. The present study comprised of a total of 100 cases, out of which 50 were in study group and 50 in control group. Cases were compared with respect to presence of Chlamydia trachomatis antibodies and maternal C- reactive protein levels.

Results: CRP levels were higher and C. trachomatis immunoglobulin G levels were more often present in the women with preterm deliveries. A total of 20 cases (40%) were found to be seropositive for IgG antibodies to C. trachomatis. The seropositive women were significantly more likely to have a preterm birth (75% [15/20] v. 40% [12/30]; p = 0.0182, odds ratio 4.50, 95% CI 1.29 to 15.67). In study group 21 cases were CRP positive (42%). The CRP positive women were significantly more likely to have a preterm birth (76.2% [16/21] v. 37.93 % [11/29]; p = 0.009, odds ratio 5.24, 95% CI 1.49 to 18.34). Thus risk of preterm delivery was greater in seropositive women and in CRP positive women.

Conclusion: The detection of maternal serum C- reactive protein and antichlamydial antibodies are valuable, non-invasive diagnostic procedure for prediction of preterm delivery and can be used as predictors of preterm delivery.


Keywords


Preterm labor, Chlamydia trachomatis, Antibody

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References


Blencowe H, Cousens S, Oestergaard M, Chou D, Moller AB, Narwal R, Adler A, Garcia CV, Rohde S, Say L, Lawn JE. National, regional and worldwide estimates of preterm birth. Lancet 2012;379(9832):2162-72.

Klein LL, Gibbs RS. Infection and Preterm Birth. Obstet Gynecol Clin N Am 2005;32:397-410.

Karinen L, Pouta A, Bloigu A, Koskela P, Paldanius M, Leinonen M et al. Serum C-reactive Protein and Chlamydia trachomatis Antibodies in Preterm Delivery. Obstet & Gynecol. 2005;106:73-80.

Andrews WW, Goldenberg RL, Mercer B, Iams J, Meis P, Moawad A, et al. The preterm prediction study: association of second-trimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecol. 2000;183:662-8.

Hollegaard S, Vogel I, Thorsen P, Jensen IP, Mordhorst CH, Jeune B. Chlamydia trachomatis C-complex serovars are a risk factor for preterm birth. In Vivo 2007;21:107-12.

Blas MM, Canchihuaman FA, Alva IE, Hawes SE. Pregnancy outcomes in women infected with Chlamydia trachomatis: a population-based cohort study in Washington State. Sex Transm Infect. 2007;83:314–8.

Hvilsom G, Thorsen P, Jeune B, Bakketeig L. C-reactive protein: a serological marker for preterm delivery. Acta Obstet Gynecol Scand 2002;81:424–9.

Moghaddam Banaem L, Mohamadi B, Asghari Jaafarabadi M, Aliyan Moghadam N. Maternal serum C-reactive protein in early pregnancy and occurrence of preterm premature rupture of membranes and preterm birth. J Obstet Gynaecol Res. 2012 May;38(5):780-6.

Ghezzi F, Massimo F, Raio L, Di Naro E, Bossi G, D’Eril G, et al. Elevated amniotic fluid C-reactive protein at the time of genetic amniocentesis is a marker for preterm delivery. Am J Obstet Gynecol 2002;186:268–73.

Claman P, Toye B, Peeling RW, Jessamine P, Belcher J. Serologic evidence of Chlamydia trachomatis infection and risk of preterm birth. CMAJ. 1995;153:259–62.

Rastogi S, Kapur S, Salhan S, Mittal A. Chlamydia trachomatis infection in pregnancy: risk factor for an adverse outcome. Br J Biomed Sci. 1999;56:94-8.

Odendaal HJ, Schoeman J. The association between Chlamydia trachomatis genital infection and spontaneous preterm labour. S Afr J Obstet Gynaecol. 2006;12:146-9.