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.

Highlights

  • An error appeared in the “corrected proof ” publication of this article [Merat S and the SD1000 Research Team

  • The following error appeared in the corrected proof publication of this article [Bradbury RS, Travers-Gustafson D, Sapp SGH, et al A Second Case of Human Conjunctival Infestation With Thelazia gulosa and a Review of T. gulosa in North America

  • In the fourth paragraph of the Case Report section, it currently states “The formalin-preserved nematode sample collected in Monterrey was sent to the California State Public Health laboratory, where it was identified morphologically as Thelazia spp

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Summary

Introduction

An error appeared in the “corrected proof ” publication of this article [Merat S and the SD1000 Research Team. This article was published with the following error: In the “Potential conflicts of interest” section, it currently states the following: “S.

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