Prior Chlamydia Trachomatis Infection and First Trimester Miscarriage in a Tertiary Health Institution in Jos, Plateau State, Nigeria

Background: Chlamydia trachomatis infection is the most common sexually transmitted disease, and it runs subtle course. This organism can cause spontaneous first trimester miscarriage even with past or latent infection by directly affecting embryonal trophoblastic tissues, or indirectly through immunoglobulin-G (IgG) antibody raised against Chlamydia heat shock protein-60 (HSP-60) cross-reacting against human HSP-60 of embryonal cells, and affectation of endometrial lining thereby causing first trimester miscarriage. The HSP-60 of Chlamydia trachomatis has amazing analogy with that of human embryo. IgG anti-Chlamydia antibody can be measured quantitatively in women with past or latent Chlamydia trachomatis infection. This study aimed to determine the association between prior Chlamydia trachomatis infection and first trimester miscarriage. Methodology: A case control study carried out in Jos University Teaching Hospital, Plateau State, Nigeria within 8-month period. The study group comprised 51 women aged 20 - 45 years with current spontaneous first trimester miscarriage while control group comprised 51 uncomplicated second-trimester women attending antenatal care at same facility matched for age with cases. A convenience sampling was used for both cases and controls. 5 ml of venous blood was collected from subjects to determine proportions and serum levels of IgG anti-Chlamydia antibody in both cases and controls using BIOS Chlamydia T. IgG ELISA kits. The subjects’ socio-demographic factors, obstetric characteristics, sexual and reproductive risk factors were obtained using study pro forma. The data obtained were compiled and analyzed using IBM-SPSS version 26. Result: This study revealed a strong association between prior Chlamydia trachomatis infection and first trimester miscarriage (OR =15.9; 3.9-66.7; P-value Conclusion: Our study revealed strong association between prior Chlamydia trachomatis infection and spontaneous first trimester miscarriage. We recommend Chlamydia trachomatis testing and treatment for preconception care prior to subsequent conception in women with first trimester miscarriage.