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KCE reports vol. 6A Prenatale zorg 96
Study Ref Population Intervention Outcomes Results
cultures positive by 9
months of age
Comments Study
type
Does screening women for chlamydial infection in pregnancy lead to improved maternal and perinatal outcomes?
Study Ref Population Intervention Outcomes Results Comments Study
Brocklehurst
and Rooney,
2002
Ryan et al.,
1990
4 [369] 11 RCTs included Antibiotic therapy or
alternative antibiotic
therapy vs. placebo or no
treatment for chlamydia in
pregnant
women
4 [368] 11,544 women cultured at
their first prenatal care visit
Tennessee, USA, from
September 1982 through
August 1985
Cervical culture at first
antenatal care visit and
prospective follow up
Women who presented
from September 1982
through December 1983
were not treated (n =
1110)
Women who presented
from Jan 1984 through
Aug 1985 were treated
with erythromycin (n =
Eradication of
maternal
infection
Preterm delivery
Side effects,
endometritis and
neonatal death:
no
significant
difference
Prevalence
Low birth weight
Infant death
Number of women with positive
cultures reduced by 90% when
treated with antibiotics
compared with placebo; OR
0.06 (95% CI 0.03 to 0.12)
Preterm delivery OR 0.89 (0.51
to 1.56)
Side effects, endometritis and
neonatal death: no significant
difference
21.1% (n = 2433/11544) were
positive for chlamydia
Increase in low birth weight in
untreated group vs. treated
group (19.6% vs. 11.0%, p <
0.0001, RR 1.78, 95% CI 1.48 to
2.18)
No difference between treated
and culture negative group (RR
0.94, 95% CI 0.79 to 1.10)
Decrease in survival in untreated
EL
EL
Being updated
type
SR 1a
Historical cohort
different calendar
periods could explain
observed differences
Infant death defined
as those who did not
leave the hospital
alive
CH 2b