Fertility in Adolescent Women Previously Treated for Genitourinary Chlamydial Infection

Abstract

496 women participating in a longitudinal study of chlamydial infection were separated into groups for analysis; 1) more than one documented chlamydial infection (68 women); 2) a single infection and at least one follow-up negative genital culture (109 women); and 3) at least two visits to one of the clinics with cultures obtained and no positive culture (319 women). Pregnancy during the follow-up period was ascertained using self-report during a telephone survey that contained questions about sexual activity contraception interim sexually transmitted disease pregnancy and live births. 104 (37.0%) women responded to the phone survey. The racial composition of the three groups did differ significantly (p = 0.014) with a lesser proportion of White women in the group with multiple infections (20.8%) than in the single-infection (33.7%) or no-documented-infection (42.8%) groups. The proportion of women who had been pregnant at least once during the follow-up period differed among the three groups (p = 0.029). The overall proportion of women with a documented pregnancy was 47.4%. In the year before the survey the single-infection group had a lower frequency of sexual intercourse than the other two groups (p = 0.049). Condom use at least 75% of the time was reported by 15-20% of the women in all three groups in the 6 months before the survey. During the previous year fewer members of the group without a positive culture used contraceptives than the other two groups (p = 0.02; no positive culture 51.6%; single infection 71.4%; multiple infections 84.2%). Those who did not become pregnant were more likely to use oral contraceptives 7-18 months before the survey (75.8%) than those who were pregnant during the follow-up period (54.9% p = 0.042). Five of the women appeared at the emergency room with pelvic inflammatory disease three from the uninfected group and two from the single-infection group. In addition two other women had emergency room diagnoses of ectopic pregnancy (both from the single-infection group).