Jyoti Kinghorn 
Having chlamydia during pregnancy can have adverse effects on the pregnancy and the baby. However, a simple course of antibiotics can cure chlamydia and support a healthy pregnancy.
What is chlamydia
Chlamydia is a sexually transmitted infection (STI) caused by the pathogen Chlamydia trachomatis. It is the most frequently reported STI worldwide, and WHO estimates that 4% of women and 2.5% of men have chlamydia globally. In the U.S. millions of people have chlamydia. According to the CDC, in the year 2021, 1.65 million cases of chlamydia were reported.
Chlamydia is transmitted when a person engages in unprotected oral, anal, or vaginal sex with someone who has chlamydia. Most cases of chlamydia are asymptomatic. 70% of women and 50% of men who get diagnosed with chlamydia have no symptoms.
Risk factors
Young women are very susceptible to getting chlamydia. The two groups with the most reported cases of chlamydia are young women who are 20-24 years of age, followed by teens 15-19 years of age. However, women over 25 can also get chlamydia in the presence of risk factors.
Risk factors for chlamydia include:
- Having a new sexual partner of unknown STI status
- Having multiple sex partners
- Having a sex partner who has chlamydia
- Having a sex partner who has other concurrent sex partners
How chlamydia affects pregnancy and newborns
Symptoms of chlamydia during pregnancy
Chlamydia is often asymptomatic. When present, the symptoms include:
- Pain or bleeding during sex
- Pain or discomfort in the lower abdomen
- Pain or burning during urination
- Unusual or increased vaginal discharge
Adverse effects of chlamydia during pregnancy
Chlamydia during pregnancy can have the following adverse effects:
- Premature rupture of membranes making the mother’s water break early and leading to premature birth
- Premature labor (before 37 weeks of pregnancy)
Adverse effects of chlamydia in newborns
Pregnant mothers who have active or untreated chlamydial infection can give the infection to their baby during vaginal birth. The newborns can develop the following complications:
- Chlamydial conjunctivitis. This is an infection of the eyes that affects 18-44% of newborns born to infected mothers.
- Chlamydial pneumonia. This is a lung infection that affects 3-16% of newborns born to infected mothers.
Both mother and baby can be treated with antibiotics to fully cure chlamydial infection.
Chlamydia screening during pregnancy
Since chlamydia is usually asymptomatic, the CDC recommends that all pregnant women 25 years of age or younger get tested for chlamydia during their first prenatal visit. Pregnant women over 25 years of age should also be routinely tested for chlamydia during their first prenatal visit if they have risk factors such as a new sex partner, multiple sex partners, or a sex partner who either has chlamydia or has other concurrent sexual relationships. If risk factors for chlamydia persist, pregnant women should be retested in their third trimester.
CDC also recommends that pregnant women who get diagnosed with chlamydia should be treated immediately and then retested after 4 weeks to perform a “test of cure” which checks if the treatment was successful at removing chlamydia.
Sometimes, the sexual partners of the treated individual do not get tested and treated themselves, or do it too late. Therefore, reinfections after chlamydia treatment are common. Therefore, the CDC also recommends that treated pregnant women should be retested 3 months after their treatment.
Chlamydia treatment during pregnancy
According to the American Pregnancy Association, antibiotic treatments to cure chlamydia are typically safe during pregnancy. A single dose or a 7-day course of oral antibiotics (taken as a pill) can cure the infection, though the exact antibiotic course will be determined by the attending physician.
Per CDC guidelines, retesting should be done 4 weeks after the treatment, and again after 3 months to check for reinfection.
Chlamydia prevention during pregnancy
Chlamydia during pregnancy can be prevented by using the following precautions:
- Having a monogamous sexual relationship with a partner who is free of STIs including chlamydia
- Not starting new sexual relationships with partners of unknown STI status
- When the STI status of a sex partner isn’t known, using protection such as condoms and dental dams while engaging in vaginal, anal, and oral sex
The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
