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Influence of different delivery modes on the clinical characteristics of Chlamydia trachomatis pneumonia


We analyzed the effects of delivery methods on Chlamydia trachomatis pneumonia in infants. Three hundred forty-four children hospitalized with Chlamydia trachomatis pneumonia were enrolled. They were divided into the vaginal delivery group and the cesarean delivery group. We compared and analyzed their age of onset, peripheral blood white blood cell count, liver enzymes, chlamydia trachomatis titers, and chest radiograph scores. Seventy-eight (22.7%) were delivered by a cesarean, and 266 (77.3%) were delivered vaginally. There were no statistically significant differences between groups when compared by sex and age (P > 0.05). Copy numbers and white blood cell counts in the peripheral blood of children with Chlamydia trachomatis in respiratory secretions of the vaginal delivery group were significantly higher than those of the cesarean delivery group (P < 0.05). The alanine aminotransferase and aspartate aminotransferase levels between groups were not statistically significant. Comparisons of admission chest radiography scores, discharge radiography scores, and score differences showed no statistical differences (P > 0.05).

Conclusion: Infants delivered by cesarean comprise approximately one-fifth of those affected. The Chlamydia trachomatis titers and peripheral blood leukocyte counts of the vaginal delivery group were higher than those of the cesarean delivery group. Age of onset, liver enzymes, pulmonary inflammation, and pneumonia absorption were not different between groups.

What is Known:
Chlamydia trachomatis is an important pathogen that causes lower respiratory tract infections in infants.
C. trachomatis is primarily transmitted to infants through the infected mother, resulting in Chlamydia trachomatis pneumonia subsequently.
What is New:
Vaginal delivery and cesarean delivery can result in Chlamydia trachomatis pneumonia transmission; however, cesarean delivery accounts for ~ 20% of cases.
C. trachomatis volume in the respiratory tract and the number of peripheral blood leukocytes in infants delivered vaginally were higher than those in infants delivered by cesarean.

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Alanine aminotransferase


Aspartate aminotransferase


World Health Organization


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This study was supported by grants from the Nanjing Medical Science and Technique Development Foundation, Nanjing, China (JQX15008), and Jiangsu Youth Medical Talent Foundation, Nanjing, China (QNRC2016087). This study was supported by the project which is correlation analysis between the genotypes of Mycoplasma pneumoniae V district and the clinical prognosis (No. 201723003). Project was also supported by the National Science Foundation for Young Scientists of China (Grant No. 81700035).

Author information

Jiejing Xu and Lili Yu are joint principal authors who contributed to the conception and design of the study and conducted the data analysis and wrote the paper; Baidi Fu helped to collect the clinical data. Deyu Zhao and Feng Liu are joint corresponding authors who supervised the study, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Correspondence to Deyu Zhao or Feng Liu.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Communicated by Peter de Winter

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Xu, J., Yu, L., Fu, B. et al. Influence of different delivery modes on the clinical characteristics of Chlamydia trachomatis pneumonia. Eur J Pediatr 177, 1255–1260 (2018). https://doi.org/10.1007/s00431-018-3147-5

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  • Chlamydia trachomatis
  • Delivery modes
  • Childhood pneumonia
  • Clinical characteristics