Chlamydia in Pregnancy

Effect on your baby

If you have chlamydia while you are pregnant, there is a chance you could pass it onto your baby if the infection is not treated:

• If chlamydia is successfully treated during pregnancy then your baby is safe from the infection
• Chlamydia can cause harm to your baby during pregnancy and you could pass it onto your baby during delivery

Your baby may develop:

• An eye infection (conjunctivitis)
• A lung infection (pneumonia)

Chlamydia is more commonly transmitted to your baby during a vaginal delivery in comparison to a caesarean. There is limited evidence to suggest that chlamydia is transmitted within the womb to your baby.

Effect on pregnancy

Chlamydia also increases the risk of developing complications such as:

• Miscarriage
• Premature birth (before 37 weeks of pregnancy)
• Stillbirth
• An infection of the amniotic sac (bag of waters) in the uterus. This type of infection is rare.
• A fever during labour or within the first few weeks after delivery

Symptoms of chlamydia in women

Chlamydia can still harm you whilst you are pregnant. Chlamydia often causes no symptoms, but may cause the following:

• Cervicitis (inflammation of the cervix)
• Chronic pelvic pain
• Increased risk of ectopic pregnancy (where the embryo implants outside the womb)
• Pelvic inflammatory disease (PID)
• Infertility
• Blockage of the Bartholin glands (glands that lubricate the vagina)
• Perihepatitis – inflammation of the liver
• Reactive arthritis – inflammation of your joints, eyes, and urethra (the tube where urine passes out of the body). This condition is more common in men

Chlamydia and infertility

Chlamydia can cause infertility if it causes PID. PID occurs when chlamydia spreads to the uterus, ovaries and fallopian tubes and causes inflammation, scarring, or blockages. The damage chlamydia can potentially cause is reduced the quicker it is treated.

Usual risks occur during pregnancy

The effects of chlamydia do not change during pregnancy. It is important to diagnose and treat chlamydia as early as possible.

This is the same as testing for chlamydia if you are not pregnant. In the UK, pregnant women are offered a free chlamydia screening test at the beginning of their pregnancy to make sure the baby won’t be exposed to the infection.

What does a chlamydia test involve?

A chlamydia test is simple and involves either a urine sample or a swab sample. The swab is a cotton bud which is wiped over the area that may be infected, such as inside your vagina.

Can chlamydia affect the result of a pregnancy test?

Chlamydia has no effect on the result of your pregnancy test and you can get both tests at the same time. A pregnancy test requires a sample of urine which can be collected at any time of the day. You can carry out most pregnancy tests from the first day you miss your period.

Yes – in most cases chlamydia is treated and cured with one course of an antibiotic during your pregnancy.

The most common antibiotics prescribed to treat chlamydia in pregnancy are:

• Doxycycline
• Erythromycin
• Amoxicillin

Azithromycin was once used as a treatment for chlamydia, but this is no longer recommended.

Are they safe during pregnancy?

Doxycycline is not suitable to take while pregnant.

Other antibiotics that are suitable to take to treat chlamydia while pregnant include:

• Erythromycin
• Amoxicillin
• Azithromycin

Should I avoid sex while I’m on treatment?

It’s advised to avoid sex (including oral sex) until you and your partner have completed treatment or to wait seven days if you are taking azithromycin before having sex again.

What if I get pregnant during treatment?

You may need further treatment and additional testing for STI’s. Speak to your doctor for advice. A ‘test of cure’ (TOC) is currently recommended during pregnancy, to ensure the infection has cleared.

If you give birth whilst on treatment, the risk of passing chlamydia onto your baby will depend on how your baby is delivered and what type of antibiotic you are taking. Your doctor may decide to offer you a TOC after delivery to ensure that your treatment was successful.

• Chlamydia and pregnancy can both be avoided by not having sex, but this is not a valid option for many people
• You can avoid pregnancy and reduce the risk of contracting STI’s by using condoms
• You can also take the contraceptive pill to avoid pregnancy, but it will not protect you from STI’s like chlamydia

Can chlamydia treatment affect the pill?

Most broad-spectrum antibiotics do not affect the combined contraceptive pill or the mini pill. This includes the antibiotics used to treat chlamydia. The only exception is if you vomit or have severe diarrhoea whilst taking the contraceptive pill and antibiotics. You would need to read your patient information leaflet or speak to a doctor or pharmacist for advice.

Can other antibiotics affect the pill?

Antibiotics that have consistently proven to have an effect on the contraceptive pill are rifampicin-like antibiotics. They include rifampicin or rifabutin and are not used to treat chlamydia.

No. If you know or think you have chlamydia, you can still use emergency contraception. Emergency contraception does not protect you against STI’s and you would still need to get tested if you are concerned.

Can I get pregnant if I have chlamydia?

Yes, in many cases chlamydia causes no symptoms and you may not even know you have it when you become pregnant. Chlamydia can affect your ability to get pregnant especially if it is left untreated in the long term. Chlamydia is one of the most common causes of PID.

Should I wait until chlamydia is cured before using emergency contraception?

You should not wait, because the time you are required to usually wait before getting tested for chlamydia is longer than the time frame in which you need to take emergency contraception for it to be effective.

Some emergency contraception only works if it is taken within a certain time frame (between 3 – 5 days) after unprotected sex. If you want to use it then you should take it as soon as possible after unprotected sex.

When can I start having sex again?

If you are being treated for chlamydia, then you are advised to wait until you and your partners treatment is finished and ideally for 7 days after that before having sex.

How does chlamydia affect an abortion?

Any infected cells in your vagina can travel up to your uterus before an abortion, so it is important to treat chlamydia before. Speak to your doctor if you are considering an abortion. You should get checked for STI’s including chlamydia before you have an abortion.