Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients

Abstract

Background We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics. Methods This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models. Results We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status. Conclusions We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

Incidence and clinical profile of ectopic pregnancies in a tertiary hospital; A two-year Retrospective study

“…In this study, 20% of ectopic pregnant women were unmarried, whereas study by Cheng Li reported only 14% and Ranji GG study had only 2% unmarried women 5,10 . This high proportion of ectopic pregnancies among the unmarried women in this study could be attributed to unprotected sexual activities thereby increased risk of sexually transmitted disease and Pelvic inflammatory disease which increases the risk of tubal damage 20 . This gives a strong reason to suspect ectopic pregnancy in a woman of reproductive age group irrespective of marital status.…”

A Prospective Study to Analyze the Specificity of Chlamydial Heat Shock Protein (Chsp60) Antibodies to Diagnose Tubal Infertility

“…Many studies revealed that serologic evidence of previous Chlamydia infection is exceptionally related to tubal infertility [4][5][6][7][8] and also decreased the success rate of a positive outcome for in vitro fertilization (IVF) [9]. The individuals with positive serology to chlamydia are at higher risk of developing the pelvic inflammatory disease (PID) [10,11].…”

Novel treatment modalities for pelvic inflammatory disease using immunomodulating therapy

“…Воспалительные заболевания органов малого таза (ВЗОМТ) представляют собой инфекционно-воспалительный процесс в верхних отделах женской репродуктивной системы с вовлечением матки, маточных труб и яичников, а в ряде случаев -смежных органов мало-го таза [1]. ВЗОМТ часто встречаются у женщин репродуктивного возраста и представляют собой серьезную проблему для общественного здравоохранения за счет их негативного воздействия на фертильность, они приводят к хронической тазовой боли, внематочной беременности и бесплодию путем нарушения нормальной архитекто-Гинекология ники органов малого таза [2]. К факторам риска развития ВЗОМТ относят особенности сексуального поведения, такие как частая смена половых партнеров, незащищенные контакты, ВЗОМТ и передающиеся половым путем инфекции, перенесенные в прошлом, внутриматочные вмешательства (гистероскопия, выскабливание стенок полости матки, вакуум-аспирация эндометрия, сязанная с прерыванием беременности, и гистеросальпингография) [3,4].…”