Association between anti-Chlamydia trachomatis antibody and ectopic pregnancy at the Federal Medical Centre, Umuahia, Abia State.

Mbamba CC1*, Nduka EC1, Agwu F1, Kalu E2, Okwara CE1
1Department of Obstetrics and Gynaecology, Federal Medical Centre, Umuahia, Abia State, Nigeria.
2Department of Microbiology, Federal Medical Centre, Umuahia, Abia State, Nigeria.
*Correspondence: Dr. Mbamba C. Charles; +234 803 340 8592;

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Background: The rise in the incidence of ectopic pregnancies is partly attributed to the increase in pelvic infection rates. Pelvic inflammatory disease (PID) is the most important cause of tubo-peritoneal damage and subsequent reproductive morbidity. Chlamydia trachomatis (CT) is the commonest bacterial sexually transmitted infection worldwide and has been found to be the commonest cause of salpingitis and PID.
Objective: To determine the association between prior Chlamydia trachomatis infection and the development of ectopic pregnancy.
Materials and method: This was a hospital-based case-control study in which 43 women with diagnosis of ectopic pregnancy confirmed at laparotomy and also with the histology of extirpated specimen (cases) and another 43 with uncomplicated intrauterine pregnancy matched for maternal age (controls) were recruited. Structured interviewer-guided questionnaire was utilized to extract relevant data. Venous blood sample was taken from each woman for quantitative anti-Chlamydia trachomatis IgG antibody titres using an automated photometer. Data was analysed using SPSS version 20.
Results: A positive IgG antibody index seen in 62.8% of the case arm was significantly higher than 23.3% in the controls (p<0.000). The mean titre in those who were positive was also higher in the case arm. The Population attributable risk percent (PAR%) was 46%. Furthermore, the association between CT infection and ectopic pregnancy was sustained when the socio-demographic characteristics and sexual and reproductive factors were controlled for. Significant risk factors for ectopic pregnancy include being single (OR 32.82 CI 2.97- 362.75), early age at sexual debut (OR 4.65; CI 1.28-16.11) and a positive history of induced abortion (OR 2.06; CI 0.78-5.38).
Conclusion: Chlamydia trachomatis causes tubo-peritoneal damage which can predispose to ectopic pregnancy. A protocol for screening and prevention should be drawn for reproductive age women.

Key words: Chlamydia trachomatis, Pelvic inflammatory disease, Ectopic pregnancy.

Cite this article: Mbamba CC, Nduka EC, Agwu F, Kalu E, Okwara CE. Association between anti-Chlamydia trachomatis antibody and ectopic pregnancy at the Federal Medical Centre, Umuahia, Abia State. Yen Med J. 2020;2(1):105–118.


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