Gyula Mészáros

Chlamydia trachomatis infection and the risk of perinatal mortality in Hungary

Abstract Introduction: Chlamydial infections of the genital tract are thought to often lead to preterm birth, which is the most important perinatal problem in Hungary. Aim of study: A multicenter study was carried out to determine the prevalence of Chlamydia trachomatis infection, risk factors for the infection and to relate the infection to perinatal mortality, accounting for potential confounding effects. Methods: The nucleic acid hybridization method (PACE2 Gen-Probe) was applied for the examination of Chlamydia trachomatis. Logistic regression analysis was used to assess risk. Results: A total of 6156 pregnant women were examined for the occurrence of Chlamydia trachomatis. The observed overall rate of chlamydial infection was 5.9%. Young age (less than 24 years old) (OR and 95% CI:1.6 (1.3–2.0)), unmarried status (1.5 (1.2–1.9)) and the high unemployment rate (2.1 (1.6–2.7)) were statistically significant predictors of the infection. In logistic regression analysis, chlamydial infection (1.9 (1.1–3.3)), high unemployment rate (1.5 (1.2–2.2)) and low birth weight (1.7 (1.1–2.7) were significant predictors of perinatal mortality. Conclusions: Testing pregnant women for diseases that can be transmitted perinatally is an important part of obstetric care. Screening for C. trachomatis of unmarried women under 24 years of age is suggested and need increased observation during labor.

Screening for Chlamydia trachomatis in asymptomatic women in Hungary

Background. A multicenter survey was carried out in order to determine the prevalence and risk factors for Chlamydia trachomatis infection in the population of asymptomatic women in Hungary. Results were used to carry out a cost‐effectiveness analysis of screening for chlamydial infection in women with asymptomatic genital infections.

Women's antenatal preferences for delivery route in a setting with high cesarean section rates and a medically dominated maternity system

To assess birth preferences in a sample of Hungarian pregnant women and identify determinants of ambivalence or clear choices for cesarean section throughout pregnancy.

Non‐medical determinants of cesarean section in a medically dominated maternity system

To assess the contribution of non‐medical factors to actual mode of delivery in a setting with high cesarean rates.

Prevalence of Chlamydia trachomatis infection in a low-risk population in Hungary

Background and Objective: Chlamydia trachomatis is the leading cause of nongonococcal urethritis and cervicitis in women. Because of the recent increases in the numbers of new cases and severe consequences, there is an urgent demand for the introduction of sensitive and specific rapid diagnostic methods. Goal: A multicenter examination involving seven centers was sponsored by the Hungarian Ministry of Health and Welfare in order to provide a survey of Chlamydia trachomatis in the gravid population. 6,161 women were tested between 1994 to 1995. Study Design: The seven centers were selected with regard to different aspects, from developed and less developed areas in the capital, two large provincial towns, and various other provincial regions reflecting either an industrial or an agricultural background. The nucleic acid hybridization method (PACE 2 Gen‐Probe, San Diego, CA) was introduced in this low‐risk population for the examination of Chlamydia trachomatis. In one center, a further two methods, antigen detection by ELISA (SYVA, CA) and cultivation on the McCoy cell line (staining with SYVA FITC‐labeled antichlamydia monoclonal antibody), were applied. Results: International surveys and experience indicate that the proportion of the population threatened by Chlamydia trachomatis is above 10%. The overall average incidence of Chlamydia trachomatis cases in this low‐risk gravid population was 5.74%. The data from the different centers ranged between 1.6% and 9.7%. The chlamydia‐infected Hungarian gravid population is below the critical 10%, but there is one Hungarian county where the value is close to 10%. Conclusions: In this provincial, industrial area, the number of unmarried and divorced gravida in a low economic situation is disproportionately high. For this disadvantaged population, permanent Chlamydia trachomatis screening was suggested. In the other centers, screening of pregnant women for Chlamydia trachomatis and the treatment of positive cases and their partners were suggested for pathological gravida with preterm labor and preterm rupture of the membranes.