Hidden Infections, Hidden Risks: Unveiling the Connection beatingetween Chlamydia & Preeclampsia

Abstract

Background

Preeclampsia is a leading cause of maternal and perinatal morbidity and mortality, characterized by new-onset hypertension and organ dysfunction after 20 weeks of gestation. While its pathophysiology involves abnormal placental development, endothelial dysfunction, and systemic inflammation, emerging evidence suggests that infections, particularly Chlamydia trachomatis, may contribute to its development. Chlamydia trachomatis is a common sexually transmitted infection (STI) that is often asymptomatic but can cause chronic inflammation and vascular damage, which are also key mechanisms in preeclampsia.

Understanding the potential link between Chlamydia infection and preeclampsia could improve early detection and prevention strategies for high-risk populations.

Methods

This study utilized a cohort analysis to compare the incidence of preeclampsia in women with a history of Chlamydia trachomatis infection versus those without. Two cohorts were defined based on medical records: women with documented Chlamydia infection (Cohort 1) and a control group without any history of Chlamydia infection. Propensity score matching was used to balance baseline characteristics between the groups. Statistical analyses included risk ratio, odds ratio, Kaplan-Meier survival analysis, and propensity-matched comparisons to assess the association between Chlamydia infection and preeclampsia risk.

Results

The findings revealed a small but statistically significant increase in the absolute risk of preeclampsia among women with a history of Chlamydia infection. While the overall increase in risk was modest, the data indicated that women with Chlamydia had a higher frequency of preeclampsia events compared to the control group. Although the Kaplan-Meier survival analysis showed no significant difference in the timing of preeclampsia onset, the increased number of instances suggests that prior Chlamydia infection may influence the severity or recurrence of the condition. These results highlight a potential physiological connection between Chlamydia-related inflammation and endothelial dysfunction, key factors in the development of preeclampsia.

Conclusions

The study supports the hypothesis that Chlamydia trachomatis infection may be a contributing factor in preeclampsia through its impact on inflammation, vascular health, and immune response during pregnancy. Given the high prevalence of Chlamydia, even a small increase in preeclampsia risk could have significant public health implications. These findings suggest that routine STI screening and early treatment could serve as a preventative measure against pregnancy complications, particularly in high-risk populations with limited healthcare access. Further research is needed to explore the biological mechanisms underlying this association and to evaluate whether targeted screening and intervention strategies could reduce the burden of hypertensive disorders in pregnancy. Integrating infectious disease management into prenatal care could ultimately lead to improved maternal and neonatal outcomes, reinforcing the importance of a holistic approach to pregnancy health.