Incidence of pelvic inflammatory disease in a large cohort of women tested for Chlamydia trachomatis: a historical follow-up study

Inger J Bakken,Sara Ghaderi

doi:10.1186/1471-2334-9-130

Abstract

BackgroundChlamydia trachomatis is a highly prevalent sexually transmitted disease. Testing rates among young Norwegian women are high. Young women diagnosed with C. trachomatis are often worried about future complications.MethodsOur cohort consisted of 24,947 women born 1970–1984 who were tested for C. trachomatis infection during 1990–2005. We linked C. trachomatis laboratory data to data on hospitalizations for pelvic inflammatory disease during 1990–2005. Cox regression analysis with time-dependent covariates adjusted for age at first test was used to assess the association between C. trachomatis history and pelvic inflammatory disease.ResultsFollow-up until the end of 2005 included 201,387 woman-years. The incidence rate of hospitalization for pelvic inflammatory disease was higher among women with prior C. trachomatis infection than among women with negative tests only (48 events during 32,057 person-years and 143 events during 169,192 person-years, corresponding to 0.15 and 0.08 per 100 person-years, respectively). The corresponding hazard ratio adjusted for age at first test was 1.69 (95% CI, 1.21–2.36).ConclusionOur data show a link between a diagnosis of C. trachomatis infection and subsequent pelvic inflammatory disease. However, pelvic inflammatory disease was a rare event irrespective of C. trachomatis status. These, together with other recent findings, can be used to reassure women worried about their future reproductive health following a diagnosis of C. trachomatis.

Highlights

IntroductionTesting rates among young Norwegian women are high
Chlamydia trachomatis is a highly prevalent sexually transmitted disease
Our study population consisted of 24,947 women who had not experienced a hospitalization for pelvic inflammatory disease prior to their first C. trachomatis test

Summary

Introduction

Testing rates among young Norwegian women are high. Young women diagnosed with C. trachomatis are often worried about future complications. There is no systematic screening program in Norway, testing rates among young women are high, as are the positivity rates [4]. By using data from a laboratory that covers all chlamydial diagnostics in a defined geographical area (a Norwegian county), we have previously shown that at the age of 25, one in six women had been diagnosed with C. trachomatis at least once [4]. Women with positive test results are often anxious about their future fertility [6,7]. A recent review has shown that the previously assumed high complication rates of C. trachomatis are being increasingly questioned [8]

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Discussion

Conclusion