Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility

Clinical Infectious Diseases, ciz429, https://doi.org/10.1093/cid/ciz429
Published: 24 August 2019

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.

New study suggests risk of birth defects in babies born to women on HIV medicine dolutegravir

European Medicines Agency, 18/05/2018

The European Medicines Agency (EMA) is evaluating preliminary results from a study which found 4 cases of birth defects such as spina bifida (malformed spinal cord) in babies born to mothers who became pregnant while taking dolutegravir. While EMA is assessing the new evidence it has issued the following precautionary advice:

  • Dolutegravir HIV medicines should not be prescribed to women seeking to become pregnant.
  • Women who can become pregnant should use effective contraception while taking dolutegravir medicines.

The study, which looked at babies born to 11,558 HIV-infected women in Botswana, showed that 0.9% of babies (4 of 426) whose mothers became pregnant while taking dolutegravir had a neural tube defect, compared with 0.1% of babies (14 of 11,173) whose mothers took other HIV medicines. Final results are expected in about a year.

Women who have been prescribed dolutegravir should not stop taking their medicine without first consulting their doctor.

EMA will update the recommendations as necessary when it concludes its assessment.

New free MOOC from Adelaide Uni: Sex and Human Reproduction

University of Adelaide, June 2018

AdelaideX’s Massive Open Online Courses (MOOCs) offer learners free to study university-level online courses on a variety of topics.  AdelaideX’s latest MOOC, Sex and Human Reproduction, will launch on Thursday 12 July and enrolments are now open. 

Led by Professor Mario Ricci (Adelaide Medical School), and made in collaboration with experts from the Robinson Research Institute, this five-week course will cover all things related to sex and reproduction – from puberty to menopause, to fertility and contraception. The course focuses on underlying human biology, common myths, and the latest medical advances.

What you’ll learn

  • Structure and function of the male and female reproductive systems
  • Regulation of reproductive processes and cycles
  • Common reproductive disorders
  • Methods of contraception and assisted reproduction
  • Real world application of cutting-edge research in reproductive medicine

This MOOC is free (with a $50 fee for a verified certificate if desired).

 

 

New sexual health videos in English, Arabic, Karen and Punjab

Health Translations Directory (Victorian Government of Australia), February  2018
Health Translations Directory has now added some new audiovisual files in English, Arabic, Karen and Punjab, developed by Family Planning Victoria. These are part of a series of videos about periods, pregnancy and contraception, for newly arrived migrant and refugee women in Australia.

The videos provide general information.lease speak to a health professional for appropriate individual advice.

(Note: These links may not work in all browsers – Internet explorer/Edge recommended)

 

Successful male contraceptive gel trial brings new form of birth control closer

Guardian, Tuesday 7 February 2017

A male contraceptive gel has been found to work reliably in a trial in primates, bringing the prospect of an alternative form of birth control for humans closer.

The product, called Vasalgel, is designed to be a reversible and less invasive form of vasectomy and in the latest study was 100% effective at preventing conception.

  • Read more of article here
  • Read full text of paper (open access) in the journal Basic and Clinical Andrology here 

Responding to Female Genital Mutilation as a women’s health issue (forum)

SHine SA, January 2017

Female Genital Mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons (WHO). It is also sometimes referred to as female genital cutting or female circumcision. There are 83,000 women and girls who have been affected by FGM in Australia. FGM has no health benefits but causes lifelong health consequences for women and girls.

Our ReFRESH forum will consist of a presentation on the topic and a personal experience of FGM. The aim is to provide participants with a better understanding of FGM. We will explore where, when, how and why FGM is practised, and how to care for survivors.

When: 9 February 2017

Where: SHine SA, 64c Woodville Road, Woodville

Time: 1.30 – 4.30 pm

Cost: $50 (Student Concession $45)

Light refreshments provided

FURTHER INFORMATION & ONLINE ENROLMENT here

Enquiries: Phone 8300 5320 / Email shinesacourses@shinesa.org.au

Download flyer here: FGM Forum