Chlamydia trachomatis and Adverse Pregnancy Outcomes: Meta-analysis of Patients With and Without Infection.
*Chlamydia trachomatis; *Perinatal infection; *Pregnancy outcomes; *Premature Birth; *Preterm birth; Adult; Childbirth; Chlamydia Infections – Complications – In Pregnancy; Chlamydia Infections – Diagnosis; Chlamydia Infections/diagnosis/*epidemiology/microbiology; Chlamydia Trachomatis; Cochrane Library; Confidence Intervals; Endometrial Diseases; Female; Fetal Membranes; Human; Humans; Infant; Infectious/diagnosis/*epidemiology/microbiology; Low Birth Weight; Medline; Meta Analysis; Newborn; Nucleic Acid Probes; Obstetric Labor; Odds Ratio; Perinatal Death; Pregnancy; Pregnancy Complications; Pregnancy Complications – Etiology; Pregnancy Outcome/epidemiology; Pregnancy Outcomes; Premature; Premature Rupture/*epidemiology; Premature/*epidemiology; PubMed; Small for Gestational Age; Systematic Review
OBJECTIVES: We conducted a meta-analysis to determine the association between Chlamydia trachomatis and adverse perinatal outcomes. METHODS: Electronic databases were searched between 1970 and 2013. Included studies reported perinatal outcomes in women with and without chlamydia. Summary odds ratios were calculated using fixed- and random-effects models. Study bias was assessed using a Funnel Plot and Begg's test. RESULTS: Of 129 articles identified, 56 studies met the inclusion criteria encompassing 614,892 subjects. Chlamydia infection in pregnancy was associated with preterm birth (OR = 1.27, 95% CI 1.05, 1.54) with a large quantity of heterogeneity (I(2) = 61%). This association lost significance when limiting the analysis to high-quality studies based on the Newcastle-Ottawa Scale. Chlamydia infection in pregnancy was also associated with preterm premature rupture of membranes (OR = 1.81, 95% CI 1.0, 3.29), endometritis (OR 1.69, 95% CI 1.20, 2.38), low birthweight (OR 1.34, 95% CI 1.21, 1.48), small for gestational age (OR 1.14, 95% CI 1.05, 1.25) and intrauterine fetal demise (OR 1.44, 95% CI 1.06, 1.94). CONCLUSIONS: This review provides evidence that chlamydia in pregnancy is associated with a small increase in the odds of multiple adverse pregnancy outcomes. The literature is complicated by heterogeneity and the fact that the association may not hold in higher quality and prospective studies or those that use more contemporary nucleic acid testing.
Olson-Chen Courtney; Balaram Kripa; Hackney David N
Maternal and child health journal
2018
2018-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s10995-018-2451-z" target="_blank" rel="noreferrer noopener">10.1007/s10995-018-2451-z</a>
Using a Clinical Decision Support Tool to Increase Chlamydia Screening Across a Large Primary Care Pediatric Network.
Adolescence; adolescent; chlamydia; Chlamydia Infections – Diagnosis; Clinical – Utilization; clinical decision support; Decision Support Systems; electronic health record; Electronic Health Records; Health Screening; Human; Office Visits; Pediatric Care; Primary Health Care; screening
We aim to demonstrate increased chlamydia screening across a large pediatric network using an electronic health record-based intervention. We developed a pop-up notification that alerted providers that chlamydia screening was recommended during a well adolescent visit, when appropriate. We compared chlamydia screening rates before and after the implementation of the alert. The screening rate for chlamydia improved from 2.40% in the year before intervention to 5.01% in the year after intervention ( P \textless .01). In conclusion, an electronic health record intervention was successfully able to significantly increase rates of chlamydia screening across a large pediatric network.
Karas David; Sondike Stephen; Fitzgibbon James; Redding Mark; Brown Miraides
Clinical pediatrics
2018
2018-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1177/0009922818803397" target="_blank" rel="noreferrer noopener">10.1177/0009922818803397</a>