ArticleAmerican journal of obstetrics & gynecology MFM2020
High rates of persistent and recurrent chlamydia in pregnant women after treatment with azithromycin.
Article in American journal of obstetrics & gynecology MFM, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- The impact of antibiotic treatment for syphilis, chlamydia, and gonorrhoea during pregnancy on birth outcomes: A systematic review and meta-analysis.Journal of global health · 2023Pooled it
- Current Evidence of Maternal Infection With Chlamydia trachomatis and Preeclampsia Risk.American journal of reproductive immunology (New York, N.Y. : 1989) · 2025Review
- Identifying the Impact ofPathogens (Basel, Switzerland) · 2024Article
- Prior Sexually Transmitted Infections and HIV in Patients With Mpox, Chicago, Illinois (June 2022-March 2023).The Journal of infectious diseases · 2024Article
- The Impact ofOpen forum infectious diseases · 2023Article
- Chlamydia trachomatis antigen induces TLR4-TAB1-mediated inflammation, but not cell death, in maternal decidua cells.American journal of reproductive immunology (New York, N.Y. : 1989) · 2023Article
- Persistence of obligate intracellular pathogens: alternative strategies to overcome host-specific stresses.Frontiers in cellular and infection microbiology · 2023Review
- Sexually transmitted infections and risk of hypertensive disorders of pregnancy.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChlamydia trachomatis is a common bacterial sexually transmitted infection that can persist or recur after antibiotic treatment. Universal screening for chlamydia in pregnancy is recommended to prevent adverse birth outcomes. Single-dose oral azithromycin has been the first-line therapy for chlamydia in pregnancy since 2006.
objectiveIn the setting of limited data and rising sexually transmitted infection rates in the United States, our goal was to document rates and risk factors for persistent or recurrent chlamydia after azithromycin treatment in pregnancy. STUDY
designThis retrospective cohort study included pregnancies with urogenital chlamydia and follow-up testing in women who delivered at an Alabama facility between November 2012 and December 2017. Pregnancies with prescribed azithromycin therapy and repeat chlamydia testing ≥21 days later were included. Chlamydia trachomatis nucleic acid amplification testing was performed on genital swab or urine samples. Descriptive characteristics and birth outcomes were compared for categories stratified by repeat test results: persistence (+ +), recurrence (+ - +), or clearance (+ -). Logistic regression models were used to identify demographic and clinical risk factors for persistent or recurrent chlamydia in pregnancy.
resultsAmong 810 women with 840 pregnancies with repeat chlamydia testing after azithromycin treatment, 114 (14%) had persistence and an additional 72 (9%) had recurrence later in pregnancy. The median time to repeat testing was 30 days (interquartile range, 24-49 days). Concomitant gonorrhea or syphilis in pregnancy was independently associated with persistent or recurrent chlamydia (adjusted odds ratio, 1.6; 95% confidence interval, 1.1-2.4).
conclusionPersistent or recurrent chlamydia after azithromycin treatment was detected in nearly 1 in 4 pregnancies with repeat testing in our urban center, highlighting the importance of performing a test of cure and ensuring partner therapy to reduce recurrent chlamydia risk.
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Registered trials
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