Association of anti-chlamydial antibodies with spontaneous miscarriage

Abstract

Miscarriage is a common adverse pregnancy outcome with significant impact on the woman’s health, her family and the community at large. Chlamydia trachomatis is the commonest Sexually Transmitted Infection worldwide and has been implicated in the aetiology of miscarriage. However, its role in spontaneous miscarriage is still unclear, as reports are conflicting. Objective: This study was to
determine the association between Chlamydia trachomatis infection and spontaneous miscarriage. Methodology: This case-control study was conducted at the Gynaecological Emergency Clinic and Antenatal Clinic of the Abubakar Tafawa Balewa University Teaching Hospital, Bauchi. Eighty-five women with spontaneous miscarriage (case group) were compared with eighty-five women with ongoing
pregnancy beyond twenty-eighth weeks of gestation and no prior miscarriage (control group) matched for age and parity. Sera were obtained from both groups and tested for Chlamydia IgG antibodies using ELISA. The data obtained, including their socio- emographic characteristics, were recorded and analysed using IBM SPSS version 26. Results: The overall sero-prevalence of Chlamydia trachomatis IgG among the participants in this study was 7.1%, while the prevalence for the case group was 10.6% and that for the control group was 3.5%. This sero-prevalence of Chlamydia trachomatis was not statistically significant between the cases and controls. (p=0.132, OR=3.237, CI=0.845-12.407). Conclusion: Demonstration of association of chlamydia with miscarriage was not established in this study despite Chlamydia trachomatis IgG being detected more in women with miscarriage than those without miscarriage, suggesting an increased risk for miscarriage from exposure to the organism. ELISA technique alone may not be sufficient
if diagnosis of pregnant women is to be undertaken. A multi-centred prospective cohort study, employing the combination of ELISA and PCR, may yield further clarity in the future.