Chlamydia trachomatis Infections: Implications for Pregnant Adolescents and Their Infants

Objective: Chlamydia trachomatis infections are common in pregnant adolescents. Previous studies have shown that treating pregnant women of all ages with erythromycin prevents transmission of this infection to their infants. However, there are no published studies on the efficacy of aggressive screening and treatment of C. trachomatis in pregnant adolescents. This study was undertaken to determine if aggressive screening for C. trachomatis in pregnant adolescents and early treatment with erythromycin can prevent complications in their newborn infants. Methods: A group of pregnant adolescents enrolled at Teen Pregnancy Service of Milwaukee was evaluated prospectively for the presence of C. trachomatis infection. Screening was performed during the 1st and 3rd trimesters by enzyme immunoassay. Adolescents with positive enzyme immunoassays for Chlamydia were treated with erythromycin for 10 days. Those with negative enzyme immunoassays were enrolled as controls. All infants born to adolescents in both groups were followed for episodes of conjunctivitis, pneumonia, and wheezing during their 1st year of life. Results: Ninety mother/infant pairs were followed during the study period. Twenty-eight mothers (31%) had positive enzyme assay tests and all received erythromycin therapy. Nasopharyngeal cultures were obtained from 60 (67%) infants; all were negative. There were no significant differences in general characteristics, development of conjunctivitis (relative risk 1.27), wheezing (relative risk 0.91), or pneumonia (relative risk 1.12) between infants born to adolescents in either group. Conclusions: We conclude that aggressive screening and treatment of C. trachomatis infection in pregnant adolescents may prevent complications in their offspring.