The global prevalence of Chlamydia trachomatis genital infection in pregnant women: a meta-analysis

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Background Chlamydia trachomatis genital infection is one of the most common sexually transmitted bacterial infections with severe detrimental effects on pregnant women and fetuses. CTGI increases the risk of ectopic pregnancy, exogenous fetal infection, and respiratory complications such as bronchitis and pneumonia. According to the different published reports, this systematic review and meta-analysis study aimed to evaluate the global prevalence of CTGI in pregnant women. Methods Initial searching was applied using valid databases of PubMed, ScienceDirect, Embase, WoS, Scopus, and Google Scholar using MeSH keywords (by October 2023). Following duplicate detection and data exclusion, the Title and Abstract of other remaining papers were evaluated (primary screening). Full-texts of selected papers were assessed (secondary screening) and eligible studies were included for data extraction (total No of investigated pregnant women and the number of positive cases). The PRISMA approach was used for paper selection, and the quality assessment was determined according to the STROBE checklist. Data meta-analysis, heterogeneity, publication bias, and the factors affecting heterogeneity index were analyzed using CMA software. The findings were presented in the Forest Plot diagram and Static tables. Besides, heterogeneity was analyzed using I2 test and diffusion bias was demonstrated in Funnel Plot. Results Among 1061 selected articles, 44 eligible investigations were enrolled for meta-analysis. The global prevalence of chlamydia trachomatis genital infection (CTGI) was found 8.4% (95% CI 5.8 – 12.1). Meta-regression analysis showed that following the increase in sample size and year of paper publication, the prevalence of Chlamydia trachomatis genital infection in pregnant women decreased significantly (p < 0.05). Conclusion The global prevalence of Chlamydia trachomatis genital infection in pregnant women is considerably influenced by some interfering factors including Age, Socioeconomic status, Geographic region, and Individual behaviors. Thus, the implementation of more comprehensive health programs for prevention, screening, and treatment seems necessary, especially for high-risk pregnant cases.

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