Prevalence of Chlamydia trachomatis in Pregnant Iranian Women: A Systematic Review and Meta-Analysis

Milad Azami; G Holamreza Badfar; Akram Mansouri; Mohammad Hossein Yekta Kooshali; Wesam Kooti; Zeinab Tardeh; Ali Soleymani; S Hamsi Abbasalizadeh

doi:10.22074/ijfs.2018.5191

Prevalence of Chlamydia trachomatis in Pregnant Iranian Women: A Systematic Review and Meta-Analysis

Int J Fertil Steril. 2018 Jun;12(3):191-199. doi: 10.22074/ijfs.2018.5191. Epub 2018 Jun 20.

Authors

Milad Azami^{1

2}, G Holamreza Badfar³, Akram Mansouri⁴, Mohammad Hossein Yekta Kooshali^{2

5}, Wesam Kooti⁶, Zeinab Tardeh¹, Ali Soleymani⁷, S Hamsi Abbasalizadeh⁸

Affiliations

¹ Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran.
² Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
³ Department of Pediatrics, Behbahan Faculty of Medical Sciences, Behbahan, Iran.
⁴ School of Nursing and Midwifery, Ahvaz Jundishapour University of Medical Sciences, Ahvaz, Iran.
⁵ Student Research Committee, School of Nursing, Midwifery, and Paramedicine, Guilan University of Medical Sciences, Rasht, Iran.
⁶ Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran.
⁷ Dezful University of Medical Sciences, Dezful, Iran.
⁸ Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic Address: Shamciabbasalizadeh@gmail.com.

Abstract

Several studies have been conducted regarding the prevalence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in pregnant Iranian women. However, it is necessary to combine the previous results to present a general assessment. We conducted the present study based on systematic review and meta-analysis studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the national and international online databases of MagIran, IranMedex, SID, MedLib, IranDoc, Scopus, PubMed, ISI Web of Knowledge, and Google Scholar search engine for certain MeSH keywords until June 16, 2017. In addition, heterogeneity, sensitivity analysis, subgroup analysis, and publication bias were performed. The data were analyzed using random-effects model and Comprehensive Meta-Analysis version 2 and P value was considered lower than 0.05. The prevalence of Chlamydia trachomatis in 11 surveyed articles that assessed 2864 pregnant Iranian women was 8.74% [95% confidence interval (CI): 5.40-13.84]. The prevalence of Chlamydia trachomatis was estimated 5.73% (95% CI: 2.09-14.73) and 13.55% (95% CI: 11.23-16.25) by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR), respectively which the difference was not significant (P=0.082). The lowest and highest prevalence of Chlamydia trachomatis was estimated in Tehran province [4.96% (95% CI: 2.45-9.810)] and Ardabil province [28.60% (95% CI: 20.61-38.20)], respectively. This difference was statistically significant (P<0.001). Meta-regression for the prevalence of Chlamydia trachomatis based on year of the studies was significant with increasing slope (P=0.017). According to the systematic review, the prevalence of Mycoplasma hominis and Urea plasma urealyticum indicated 2 to 22.8% (from 4 articles) and 9.1 to 19.8% (from 3 articles), respectively. There was no evidence of publication bias (P value for Begg and Eggers' tests was 0.161 and 0.173, respectively). The prevalence of Chlamydia trachomatis is high among pregnant Iranian women. Screening pregnant women as part of preventive measures seem necessary considering the potential for maternal and fetal complications.

Keywords: Chlamydia trachomatis; Meta-Analysis; Mycoplasma Hominis; Pregnant Women; Ureaplasma Urealyticum.