OBJECTIVE: The primary aim of this study was to assess the rate and load of amniotic fluid Chlamydia trachomatis DNA and their associations with intra-amniotic infection and intra-uterine inflammatory complications in women with preterm prelabor rupture of membranes (PPROM). The secondary aim was to assess the short-term morbidity of newborns from PPROM pregnancies complicated by amniotic fluid C. trachomatis DNA. METHODS: A retrospective study of 788 women with singleton pregnancies complicated by PPROM between 24 + 0 and 36 + 6 weeks of gestation was performed. Transabdominal amniocenteses were performed at the time of admission. C. trachomatis DNA in the amniotic fluid was assessed by real-time polymerase chain reaction using a commercial AmpliSens® C. trachomatis/Ureaplasma/Mycoplasma hominis-FRT kit, and the level of Ct DNA was quantified. RESULTS: Amniotic fluid C. trachomatis DNA complicated 2% (16/788) of the PPROM pregnancies and was present in very low loads (median 57 copies DNA/mL). In addition to amniotic fluid C. trachomatis DNA, other bacteria were detected in 62% (10/16) of the C. trachomatis DNA-complicated PPROM pregnancies. Amniotic fluid C. trachomatis DNA was associated with intra-amniotic infection, histologic chorioamnionitis (HCA), and funisitis in 31%, 47%, and 33%, respectively. The presence of C. trachomatis DNA accompanied by Ureaplasma species in the amniotic fluid was associated with a higher rate of HCA than the presence of amniotic fluid C. trachomatis DNA alone. The composite neonatal morbidity in newborns from PPROM pregnancies with amniotic fluid C. trachomatis DNA was 31%. CONCLUSION: The presence of C. trachomatis DNA in the amniotic fluid is a relatively rare condition in PPROM. Amniotic fluid C. trachomatis DNA in PPROM is not related to intensive intra-amniotic and intr-auterine inflammatory responses or adverse short-term neonatal outcomes.

1st Department of Obstetrics and Gynecology Medical University of Warsaw Warsaw Poland

Biomedical Research Center University Hospital Hradec Kralove Hradec Kralove Czech Republic

Center for Molecular Medicine and Genetics Wayne State University Detroit MI USA

Department of Clinical Immunology and Allergy University Hospital Hradec Kralove Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Poland

Department of Epidemiology and Biostatistics Michigan State University East Lansing MI USA

Department of Genetics and Bioinformatics Domain of Health Data and Digitalisation Institute of Public Health Oslo Norway

Department of Infectious Diseases University Hospital Hradec Kralove Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Czech Republic

Department of Obstetrics and Gynecology Sahlgrenska Academy Gothenburg University Gothenburg Sweden

Department of Obstetrics and Gynecology University Hospital Hradec Kralove Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Czech Republic

Department of Obstetrics and Gynecology University of Michigan Ann Arbor MI USA

Fingerland Department of Pathology University Hospital Hradec Kralove Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Czech Republic

Institute of Clinical Biochemistry and Diagnostics University Hospital Hradec Kralove Faculty of Medicine in Hradec Kralove Charles University Hradec Kralove Czech Republic

Perinatology Research Branch Division of Obstetrics and Maternal Fetal Medicine Division of Intramural Research Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health U S Department of Health and Human Services Bethesda MD and Detroit MI USA

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