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LETTERS:
Woody Caan
Preterm delivery in primiparous women at low risk: Could epidemic chlamydia contribute to rise in preterm births?
BMJ 2006; 332: 1094-b [Full text]
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[Read Rapid Response] Role of chronic Chlamydia trachomatis infection in preterm birth
Anneli Pouta   (19 May 2006)

Role of chronic Chlamydia trachomatis infection in preterm birth 19 May 2006
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Anneli Pouta,
Chief physician
National Public Health Institute, Aapistie 1, P.O. Box 310, FIN-90101, Oulu, Finland

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Re: Role of chronic Chlamydia trachomatis infection in preterm birth

Editor, Langhoff-Roos discussed recently the increase of preterm births among low- risk mothers 1. In his letter, Professor Caan pointed out the possible role of chlamydia infections 2

In our population-based prospective study we have investigated the association between spontaneous preterm delivery and Chlamydia trachomatis and highly sensitive C-reactive protein (hsCRP) levels in maternal serum obtained during the first trimester as markers of low-grade systemic chronic inflammation 3. HsCRP levels were higher and C. trachomatis IgG levels (pools and individual serotypes) were more often present in the women with preterm compared to term deliveries. When C. trachomatis IgG antibodies and elevated hsCRP were present simultaneously, the estimated risk for preterm delivery was fourfold (OR 4.3, 95% CI 2.0-9.3). Among the women delivered at or before 34 weeks of gestation, the estimated risk was even more evident (OR 5.6, 95% CI 2.1-14.5). The results of our study suggest that chronic chlamydial infection, already in first trimester is associated with preterm delivery.

Anneli Pouta, Chief physician, PhD, specialist in perinatology
National Public Health Institute, P.O. Box 310, FIN-90101 Oulu, Finland anneli.pouta@ktl.fi

Competing interests: none declared

References

1. Langhoff-Roos J, Kesmodel U, Jacobsson B, Rasmussen S, Vogel I. Spontaneous preterm delivery in primiparous women at low risk in Denmark: population based study. BMJ 2006;332: 937-9.

2. Caan W. Preterm delivery in primiparous women at low risk Could epidemic chlamydia contribute to rise in preterm births? BMJ 2006;332:1094.

3. Karinen L, Pouta A, Bloigu A, Koskela P, Paldanius M, Leinonen M, Saikku P, Järvelin MR, Hartikainen AL. Serum C-reactive protein and Chlamydia Trachomatis antibodies in preterm delivery. Obstet Gynecol 2005;106:73-80.

Competing interests: None declared