Detection of Chlamydia trachomatis antigen in spontaneous abortions. Is this organism a primary or secondary indicator of risk?

In order to investigate whether or not Chlamydia trachomatis infection is a risk factor for pregnancy loss, 77 spontaneous abortion patients (6-24 wee ks gestation), admitted to gynaecology emergency of Safdarjang Hospital, Ne w Delhi, India. Twenty-five pregnant women (6-16 seeks gestation) attending the same hospital for induced abortion, were included in the study. C. tac homatis antigen was detected in endometrial curretage tissue by enzyme immu noassay (EIA). The detection rate was 15.6% (12/77) among spontaneous abort ion patients and 4% (1/25) among women undergoing induced abortion. There w as no statistically significant association between the mean age/mean gesta tional age of those experiencing spontaneous abortion, with and without C. trachomatis infection (26.9 years versus 25.06 years and 11.1 weeks versus 9.6 weeks, respectively). High prevalence of C. trachomatis was found in mu ltigravidae and parous spontaneous abortion patients, compared with that in primigravidae and nulliparous Chlamydia-negative spontaneous aborters (75. 0% versus 25.0%; 66.7% versus 33.3%, respectively). The prevalence of chlam ydial antigen in patients with no prior history of spontaneous abortion was 16.1% (10/62) compared with 18.1% (2/11) in women with one prior abortion. Further study is required to determine whether C. trachomatis infection is a primary or secondary indicator of risk.