Indian Journal of Dermatology, Venereology and Leprology Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) ISSN: 0378-6323 EISSN: 0973-3922 Vol. 69, Num. 6, 2003, pp. 394-395

Indian Journal of Dermatology, Venereology, Leprology, Vol. 69, No. 6,Nov-Dec , 2003, pp. 394-395

Studies

Chlamydia trachomatis seropositivity during pregnancy

Sawhney MP, Batra RB

Departments of Dermatology & STD and Pathology & Immunology, Command Hospital (EC), Kolkata - 700027
Correspondence Address:Base Hospital, Barrackpore - 700120

Code Number: dv03074

ABSTRACT

The reported prevalence of Chlamydia trachomatis infection among pregnant women has ranged widely from 2 to 30 percent in various studies.[1] Young age, especially adolescence, is a strong predictor of chlamydial infection. Antepartum chlamydial infection appears to play an important part in amnionitis, postpartum endometritis and postabortal salpingitis.[1] Further, it was found that the frequency of fetal complications was higher and the birth weight lower in children whose mothers had chlamydial infection during pregnancy as compared to those whose mothers were uninfected.[2] Hence it is essential to identify patients at risk and treat them with antichlamydial drugs to prevent any such complications. Detection of Chlamydia trachomatis antibodies by ELISA has been recently developed as a diagnostic tool.[2],[3],[4],[5],[6],[7] We thus decided to find out the prevalence of chlamydial infection in antenatal cases.

METHODS

The study was conducted in 24 antenatal cases admitted in Command Hospital (EC), Kolkata during the month of January 2003 and in 10 healthy non-pregnant controls. Blood was tested for Chlamydia trachomatis antibodies by Microwell ELISA (Diagnostic Automation Inc., California 91302, USA) in all the cases and controls.

RESULTS

The average age of the cases was 26.5 years and that of the controls was 28 years. The prevalence of antichlamydial antibodies is shown in [Table - 1]. Only one antenatal case gave a history suggestive of antepartum pelvic inflammatory disease and her blood was borderline positive for IgM antibodies.

DISCUSSION

Genancy et al[2] found IgM seropositivity to C. trachomatis in 13.64% of the cases and 5.47% of the controls by ELISA technique. Rastogi et al[8] in a study in antenatal cases in India found a high seropositivity and a low seropositivity to IgM antibodies in 29.4% and 27.7% respectively. However, our study has shown positive results to IgM in 20.83% and borderline positive in another 12.5% of cases. Only 10% of the controls were positive for IgA antibodies and none for IgM or IgG antibodies. Moreover, another 4.17% were positive and 8.33% borderline positive for IgG antibodies, i.e. an overall positivity of 45.83%. IgM antibodies suggest an acute infection.[9] This highlights the importance of performing this test in all our antenatal cases to treat the infected and prevent any maternal or neonatal antenatal or postnatal complications.

The difference in seropositivity rates between the cases and the controls is due to increased susceptibility of antenatal cases to C. trachomatis infection during sexual activity and increased proliferation of the organism in those with antepartum infection, due to the lowered immunity in pregnancy.[1]

REFERENCES

1.	Adimora AA, Hamilton H, Holmes KK, Sparling PF, editors. Sexually transmitted diseases in pregnancy. In: Sexually transmitted diseases. Companion Handbook. 2nd ed. New York: McGraw-Hill; 1994. p. 335-51.  Back to cited text no. 1
2.	Gencay M, Koskiniemi M, Saikku P, Puolakkainen M, Raivio K, Koskela P, et al. Chlamydia trachomatis seropositivity during pregnancy is associated with perinatal complications. Clin Infect Dis 1995;21:424-6.  Back to cited text no. 2  [PUBMED]
3.	Poussin M, Fluentes V, Corbel C, Prin L, Eb F, Orfilla J. Capture-ELISA: a new assay for the detection of immunoglobulin M isotype antibodies using Chlamydia trachomatis antigen. J Immunol Methods 1997;204:1-12.  Back to cited text no. 3
4.	Dereli D, Coker M, Ertem E, Serter D, Tanac R, Tez E. Chalamydial Col MPS Sawhney infection in infants. J Trop Pediatr 1996;42:233-6.  Back to cited text no. 4  [PUBMED]
5.	Bas S, Cunningham T, Kvien TK, Glennas A, Melby K, Vischer TL. Synovial fluid and serum antibodies against Chlamydial in different forms of arthritis: intra-articular IgA production in Chlamydia sexually acquired reactive arthritis. Br J Rheumatol 1996;35:548-52.  Back to cited text no. 5  [PUBMED]
6.	Bas S, Cunningham T, Kvien TK, Glennas A, Melby K, Vischer TL. The value of isotype determination of serum antibodies against Chlamydia for the diagnosis of Chlamydia reactive arthritis. Br J Rheumatol 1996;35:542-7.  Back to cited text no. 6  [PUBMED]
7.	Bas S, Vischer TL. Chlamydia trachomatis antibody detection and diagnosis of reactive arthritis. Br J Rheumatol 1998;37: 1054-9.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]
8.	Rastogi S, Das B, Mittal A. Serum IgM to Chlamydia trachomatis in pregnancy: its usefulness for screening. Br J Biomed Sci 2002;59:30-4.  Back to cited text no. 8
9.	Gencay M, Koskiniemi M, Ammala P, Fellman V, Narvanen A, Wahlstrom T, et al. Chlamydia trachomatis seropositivity is associated both with stillbirth and preterm delivery. APMIS 2000;108:584-8.  Back to cited text no. 9

Copyright 2003 - Indian Journal of Dermatology, Venereology, Leprology

The following images related to this document are available:

Photo images