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.

STI’S on the rise in SA – free campaign resources (SHINE SA media release)

SHINE SA, April 2, 2019

Sexually transmitted infection (STI) rates are on the rise in South Australia, with around 1 in 20 young people infected with chlamydia¹. Left untreated chlamydia can lead to infection of the reproductive systems and long term consequences. Having one STI also increases the risk of being infected with another. As such it’s important that young people in SA are encouraged to practise safer sex as well as getting a sexual health check.

In response to this rise in STIs, SHINE SA is excited to announce the launch of their Sexual Health Check campaign and related resources for use across South Australia. These resources can be used by organisations including universities, secondary schools, youth services, general practice and community health services.

The Sexual Health Check campaign aims to raise awareness of STIs as well as highlight how easy it is to get a sexual health check.
According to the most recent epidemiological report released by SA Health in 2017, STI and blood borne viruses (BBVs) have jumped 14% compared to the previous five years.

In 2017:

  • there were 8,181 new infections of STIs and BBVs, this is a 7% increase compared to 2016
  • 77% of infections were in people aged 15 to 29 years.

SHINE SA encourages young people to receive a sexual health check at a SHINE SA clinic, their local doctor or Aboriginal Health service. SHINE SA offers FREE sexual health checks as well as counselling to South Australians under the age of 30 with a Medicare Card.

Dr Amy Moten, SHINE SA’s Coordinator of Medical Education said:
“STIs are on the rise, so practicing safer sex and having regular testing is vital. Left untreated, serious infection may occur and lead to complications such as infertility, chronic pelvic pain and ectopic pregnancy. As most people don’t have any symptoms, lack of testing contributes to the continued spread of the disease”.

SHINE SA hopes other health and education organisations and media outlets can assist by promoting and sharing the Sexual Health Check campaign. By doing so we can help raise awareness of STIs in the community and encourage young people to access sexual heath checks.

  • The free campaign resources including a Sexual Health + STIs FAQ booklet, posters and social media tiles can be downloaded here
  • For further information contact Tracey Hutt, Director Workforce Education and Development, by email here 
  • Download this media release

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¹ http://www.sti.guidelines.org.au/populations-and-situations/young-people