Chlamydia infection is a sexually transmitted disease (STD) that affects women and men. It is a bacterial infection caused by a strain of Chlamydia trachomatis. It is mainly spread via unprotected sexual activities, including oral and anal sex.
The disease has been dubbed a “silent infection” due to its lack of outward symptoms, especially during the early stages of the disease. Unfortunately, this is also a significant reason why chlamydia is the most commonly reported STI in the U.S.
Women, in particular, are more likely to experience asymptomatic chlamydia. One study estimated that 40% to 96% of women who contracted chlamydia were asymptomatic.
Chlamydia infection is not fatal and can be treated easily using antibiotics. However, the delay in treatment because of the lack of initial symptoms can lead to severe complications and cases of chlamydia while pregnant.
Chlamydia in Pregnancy
Cases of chlamydia in pregnancy are relatively common. Contracting chlamydia while pregnant or becoming pregnant while infected with chlamydia usually happens because women are unaware they have the disease.
Although chlamydia is typically spread via unprotected sex, the disease does not require penetration to spread. Simply touching infected genitals already allows transmission of the Chlamydia trachomatis bacteria. As such, chlamydia during pregnancy can be passed on to the newborn baby during birth.
Chlamydia in Pregnancy: First Trimester
Since many cases of chlamydia in women are asymptomatic, it is best to get tested for the disease as early as the first prenatal visit or anytime during the first trimester if the mother suspects having the infection.
During the first trimester, the CDC encourages pregnant women under 25 to get tested for Chlamydia trachomatis infections. This recommendation also applies to older women with a higher chance of infection, such as those with a history of chlamydia or other STIs.
It is also a good idea for women planning to or actively trying to get pregnant to get screened as a precaution.
Chlamydia in Pregnancy: Third Trimester
The CDC also recommends expecting mothers in their last trimester undergo another round of screening for chlamydia, particularly if they are under 25 years old or at high risk of infection.
Some factors contributing to high chlamydia risk include:
- History of chlamydia or other sexually transmitted infections
- New or several sexual partners
- A sexual partner who engages in sex with other people
- Continued unprotected sex with current or new partners
Contracting chlamydia during the third trimester and leaving it untreated can be passed on to the baby during birth. This can result in severe child health consequences, including conjunctivitis (eye infection) and pneumonia (lung infection).
Moreover, untreated chlamydia during the last trimester of pregnancy increases the mother’s risk of pregnancy complications. In addition, it can potentially cause premature labor or the newborn’s low weight at birth.
Symptoms of Chlamydia during Pregnancy
The symptoms of chlamydia during pregnancy are essentially the same ones that women who aren’t pregnant experience.
These include the following:
- Painful or burning sensation during urination
- Vaginal discharge
- Abnormal color of discharge
- Painful sexual intercourse
- Lower abdomen or pelvic pain
- Cervix inflammation or cervicitis
- Vaginal bleeding in between periods or after sex
- Reactive arthritis, though this is more commonly seen in men
If chlamydia is left untreated, it can potentially spread to a woman’s fallopian tubes. In such cases, the infection can trigger pelvic inflammatory disease (PID), which is severe enough to be considered a medical emergency.
The symptoms of PID include:
- Nausea
- Fever
- Severe and persistent pelvic pain
- Abnormal vaginal bleeding
The Chlamydia trachomatis bacteria may also infect the rectum through anal sex. Chlamydial infection in the rectum is more likely asymptomatic, especially among women.
However, when symptoms present themselves, it typically includes rectal pain, rectal discharge, and abnormal rectal bleeding.
Chlamydia can also affect the throat as a result of oral sex. Its symptoms include sore throat, coughing, and fever.
How Will Chlamydia Affect My Pregnancy?
In general, the effects of chlamydia remain the same for women, regardless of whether they are pregnant. Therefore, the symptoms stay the same and, if not treated promptly, can cause PID, infertility, and inflammation throughout the genital or reproductive tract.
The primary difference when contracting chlamydia while pregnant is it increases the woman’s risk of developing health complications and adverse pregnancy outcomes.
Some of these are:
- Miscarriage
- Premature rupture of membranes or early water break
- Infection of the amniotic sac
- Stillbirth
- Ectopic pregnancy, or when the embryo is implanted outside the womb
- Premature birth or going into delivery before 37 weeks
- Fever during or after labor
If the infection is left untreated until it is time for delivery, the newborn baby is likely exposed to and infected by the bacteria. When this happens, the baby may develop either eye infections or pneumonia. They may also be born underweight or with a lower birth weight.
A chlamydia infection may not severely affect the pregnancy if it remains asymptomatic. However, if and when the chlamydial infection symptoms present, the expectant mother will generally experience greater discomfort and vaginal pain.
Can Chlamydia Cause Miscarriage in Early Pregnancy?
Yes, chlamydia can potentially cause a miscarriage during pregnancy. A study published in the Emerging Infectious Diseases journal observed a link between miscarriage and Chlamydia trachomatis bacterial infection.
However, treating the infection promptly can significantly reduce the risks of miscarriage and other adverse effects. Successful chlamydia treatment may also help prevent a recurrent miscarriage.
Researchers support screening for chlamydia as early as possible to reduce miscarriage risks and get tested for chlamydia after experiencing a miscarriage.
Can My Baby Get Chlamydia from Me?
Untreated chlamydia subjects the unborn fetus to potential infection. Although there is no evidence that chlamydia can spread through the pregnant mother’s bloodstream and affect the fetus in the womb, the unborn child can be exposed to the C. trachomatis bacteria during labor.
When the baby passes through the vaginal or birth canal, they come into contact with the chlamydial bacteria. Around half of the newborns whose mothers have untreated chlamydia end up catching the infection when born. It typically results in conjunctivitis or eye infection and pneumonia or chest infection.
How Is Chlamydia Diagnosed?
Chlamydial infections are diagnosed via screenings or tests. Such procedures are relatively simple, often requiring a small sample for laboratory testing.
There are two ways to screen for and diagnose chlamydia:
Urine test
Like pregnancy tests and drug tests, the healthcare facility or lab will collect a sample of the patient’s urine and send it for testing. However, one study noted that having a urinary tract infection may cause a false-positive chlamydia result.
Swab test
A swab test for women involves taking a swab of discharge from their cervix. The swab is then subjected to culture or antigen testing for the C. trachomatis bacteria. In some cases, women may swab their vaginas rather than the cervix. However, data shows self-vaginal swabs are as diagnostic as doctor-obtained cervical swabs.
Doctors may require either or both of the tests. In addition, some doctors also conduct physical examinations to check for discharge, sores, and other irregularities, particularly in the patient’s genitals.
Urine and swab results can take several days before they are available. However, if they turn out positive, the doctor discusses treatment options with the patients.
Individuals who have already received treatment for chlamydia are advised to undergo follow-up tests around three months after completing their treatment.
Treating a Chlamydial Infection
Like most bacterial STIs, antibiotics can treat and cure chlamydia infections. Over 95% of individuals with chlamydia are successfully cured after following their prescribed antibiotic treatment.
For some patients, doctors only prescribe a one-time antibiotic dose. In other cases, patients must undergo a full treatment course involving once-daily or multiple daily medication intakes.
A full antibiotic treatment course for chlamydia can take as short as five days and up to 10 days or two weeks. However, doctors may prescribe a more extended treatment course for patients with a higher likelihood of chlamydia complications.
Generally, the infection gets resolved within one to two weeks of taking antibiotics. The two most popular antibiotics for treating chlamydia are:
●Doxycycline
This tetracycline antibiotic is commonly prescribed for acne, urinary tract, infections, and sexually transmitted diseases. For chlamydia, doxycycline is frequently prescribed as a 100 mg twice-daily treatment for seven days.
●Azithromycin
This macrolide antibiotic is commonly prescribed for skin, respiratory, and STIs. For chlamydia, doctors usually prescribe a one-gram single dose or a loading dose, then a 500 mg dose taken daily for two days.
As part of the treatment, patients are also advised to abstain from sexual intercourse or penetrative activities involving sex toys. Partners of women with chlamydia are also required to undergo treatment to prevent recurrent infections, particularly during pregnancy.
How Is Chlamydia Treated During Pregnancy?
Treatment for chlamydia during pregnancy is primarily the same as treatments for men and women who are not pregnant or breastfeeding. Individuals diagnosed with the infection are prescribed antibiotics and required to follow the dosage and duration of the treatment strictly.
Abstaining from sexual activities is also highly recommended when treating expectant mothers with chlamydia.
What Antibiotics Cure Chlamydia During Pregnancy?
The only differences when treating chlamydia during pregnancy are the prescribed antibiotics.
Azithromycin is recognized for having the highest efficacy rate in treating chlamydia. Although there are some concerns regarding its use during pregnancy, studies indicate it is safe and effective.
As per CDC recommendation, the recommended antibiotic regimen for pregnant women with chlamydial infections is a single oral dose of one gram of azithromycin.
However, doxycycline is contraindicated for expectant mothers in their second and third trimesters. Taking doxycycline during this time raises the risk of tooth or bone discoloration in the fetus.
Instead of doxycycline, expecting mothers may be prescribed either of the following:
●Amoxicillin.
This is a penicillin-type of antibiotic. It is commonly prescribed in a 500 mg dose used 3 times daily for one week.
●Erythromycin.
This is a macrolide type of antibiotic, similar to azithromycin. It used to be primarily prescribed as an alternative chlamydia treatment during pregnancy. While some doctors may still prescribe erythromycin, the CDC no longer recommends it as an alternative treatment due to gastrointestinal side effects and a link to adverse pregnancy complications.
How Can I Prevent Getting Chlamydia During Pregnancy?
The best way to prevent chlamydia infection during pregnancy is to practice safe, protected sex. This also holds even if a person is not pregnant or male.
In particular, sexually active individuals are advised to use condoms or other barrier methods of contraception to prevent chlamydia. Aside from condoms, these include diaphragms, contraceptive sponges, and cervical caps. Although intrauterine devices and birth control pills are relatively effective contraceptives, they do not protect women against chlamydia infections.
Other ways to protect against contracting chlamydia during pregnancy are to:
●Undergo regular screening for STIs, especially before and after sex with a new partner.
●Avoid engaging in sex before you or your partner get tested.
●Use a barrier method of protection with every new sexual partner.
●Avoid sharing sex toys, especially penetrative ones.
●Never use penetrative sex toys without proper covering, such as a condom.
●Refrain from engaging in sexual activity while pregnant.
Can Pregnancy Cause a False Positive Chlamydia Test?
False-positive chlamydia test results are pretty rare. However, when they do happen, it is usually due to a human error in the lab or with the test itself.
Pregnancy does not affect chlamydia test results, regardless of whether the infection is done by collecting urine or swab samples. Inversely, neither chlamydia infection nor testing affects the outcome of pregnancy tests.
When to See a Doctor
It is highly recommended to seek professional medical assistance upon feeling discomfort during urination or experiencing other symptoms of chlamydia. Moreover, it is essential to consult a doctor as soon as women discover their current partner or one of their recent partners has been diagnosed with chlamydia.
Expecting mothers should see a medical specialist and get screened for chlamydia during or after their first prenatal visit. Expectant or expecting mothers are also recommended to see a doctor and to get re-tested for potential chlamydia during their third trimester to ensure their and their baby’s safety.
Frequently Asked Questions (FAQs)
Chlamydia trachomatis infections during pregnancy are relatively common. Aside from being one of the most common sexually transmitted diseases, chlamydia infections are often asymptomatic, especially in women. This increases the chances of contracting the disease during pregnancy or while attempting to get pregnant.
Yes, treating chlamydia during pregnancy is safe. Treatment usually takes around two weeks, with expecting mothers advised to undergo follow-up testing three to four weeks after treatment to ensure the infection is treated successfully.
Pregnant people with chlamydia are given antibiotics to treat the disease. The only difference between treatments for non-pregnant women is the antibiotic prescribed. For pregnant women and breastfeeding mothers, doctors typically prescribe amoxicillin or erythromycin.
Having chlamydia does not typically affect the actual pregnancy experience itself. However, it can affect the baby upon delivery or birth. Since chlamydia is passed through contact, babies typically contract the bacterial infection when they pass through the vagina. This can lead to eye infection, lung infection, low birth weight, and premature birth.
No, chlamydia is not a life-threatening sexually transmitted disease, regardless of whether it is contracted during pregnancy. But while it is not directly fatal, it can still cause severe complications if left untreated, particularly adverse pregnancy outcomes. Other potential complications are infertility and an inflamed uterus for the mother or pneumonia for the newborn baby. In addition, if chlamydia is not treated, it can lead to complications like human immunodeficiency virus.
