OBJECTIVE: The primary aim of this study was to assess the rate and load of 
amniotic fluid Chlamydia trachomatis DNA and their associations with 
intra-amniotic infection and intra-uterine inflammatory complications in women 
with preterm prelabor rupture of membranes (PPROM). The secondary aim was to 
assess the short-term morbidity of newborns from PPROM pregnancies complicated 
by amniotic fluid C. trachomatis DNA.
METHODS: A retrospective study of 788 women with singleton pregnancies 
complicated by PPROM between 24 + 0 and 36 + 6 weeks of gestation was performed. 
Transabdominal amniocenteses were performed at the time of admission. C. 
trachomatis DNA in the amniotic fluid was assessed by real-time polymerase chain 
reaction using a commercial AmpliSens® C. trachomatis/Ureaplasma/Mycoplasma 
hominis-FRT kit, and the level of Ct DNA was quantified.
RESULTS: Amniotic fluid C. trachomatis DNA complicated 2% (16/788) of the PPROM 
pregnancies and was present in very low loads (median 57 copies DNA/mL). In 
addition to amniotic fluid C. trachomatis DNA, other bacteria were detected in 
62% (10/16) of the C. trachomatis DNA-complicated PPROM pregnancies. Amniotic 
fluid C. trachomatis DNA was associated with intra-amniotic infection, 
histologic chorioamnionitis (HCA), and funisitis in 31%, 47%, and 33%, 
respectively. The presence of C. trachomatis DNA accompanied by Ureaplasma 
species in the amniotic fluid was associated with a higher rate of HCA than the 
presence of amniotic fluid C. trachomatis DNA alone. The composite neonatal 
morbidity in newborns from PPROM pregnancies with amniotic fluid C. trachomatis 
DNA was 31%.
CONCLUSION: The presence of C. trachomatis DNA in the amniotic fluid is a 
relatively rare condition in PPROM. Amniotic fluid C. trachomatis DNA in PPROM 
is not related to intensive intra-amniotic and intr-auterine inflammatory 
responses or adverse short-term neonatal outcomes.