DELAYED CARE OF PELVIC INFLAMMATORY DISEASE AS A RISK FACTOR FOR IMPAIRED FERTILITY

被引:205
作者
HILLIS, SD
JOESOEF, R
MARCHBANKS, PA
WASSERHEIT, JN
CATES, W
WESTROM, L
机构
[1] Division of Sexually Transmitted Diseases/Human Immunodefcciency Virus Prevention, National Center for Prevention Services, Atlanta, Georgia
[2] Division of Training, Epidemiology Program Office, Atlanta, Georgia
[3] Centers for Disease Control and Prevention, Department of Obstetrics and Gynaecology, University Hospital, Lund
关键词
PELVIC INFLAMMATORY DISEASE; HEALTH CARE-SEEKING BEHAVIOR; INFERTILITY; ECTOPIC PREGNANCY;
D O I
10.1016/S0002-9378(11)90790-X
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
OBJECTIVE: We evaluated the relationship between delayed care of symptomatic pelvic inflammatory disease and impaired fertility. STUDY DESIGN: We used data from a cohort of women with clinically recognized pelvic inflammatory disease. Case patients were women with either ectopic pregnancy or infertility (n = 76); controls were women with intrauterine pregnancies (n = 367). RESULTS: Women who delayed seeking care for pelvic inflammatory disease were three times more likely to experience infertility or ectopic pregnancy than women who sought care promptly after adjustment for age, organism, year of diagnosis, and history of recent gynecologic events (95% confidence interval = 1.27, 6.11). This association was strongest for women with chlamydia; 17.8% (18/101) of those who delayed seeking care had impaired fertility, whereas 0.0% (0/13) of those who sought care promptly suffered known sequelae. CONCLUSIONS: Women with pelvic inflammatory disease who delay seeking care are at increased risk for infertility and ectopic pregnancy. Furthermore, our data suggest that prompt evaluation and treatment of chlamydial pelvic inflammatory disease can prevent these sequelae.
引用
收藏
页码:1503 / 1509
页数:7
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