Rates of pelvic inflammatory disease and ectopic pregnancy in Australia, 2009–2014: ecological analysis of hospital data

Goller, Jane L; Livera, Alysha M De; Guy, Rebecca; Low, Nicola; Donovan, Basil; Law, Matthew; Kaldor, John; Fairley, Christopher K; Hocking, Jane S

doi:10.1136/sextrans-2017-053423

Cited by 17 publications

(13 citation statements)

References 26 publications

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“…The result involving the association of PID with ectopic pregnancy of our study is consistent with previous studies 17, 18. Tubal damage caused by PID increases the risk of ectopic pregnancy and infertility.…”

Section: Discussionsupporting

confidence: 93%

The Risk of Gynecologic and Urinary Tract Cancer with Pelvic Inflammatory Disease: A Population-Based Cohort Study

Lin¹,

Wang²,

Lee³

et al. 2019

J. Cancer

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Purpose: The aim of the study was to determine the association between pelvic inflammatory disease (PID) and breast, colorectal, gynecologic and urinary tract cancer.Methods: The source of data was a longitudinal dataset compiled by the Longitudinal Health Insurance Database 2000 (LHID2000) which was collected by the National Health Insurance program. Cases of PID, at least two outpatient visits and one admission, were diagnosed from 2000 to 2013. The data for controls, age matched women who were not diagnosed with PID from 2000 to 2013, were also obtained.Results: A total of 47,333 PID cases and 189,332 for control group were included in the study. The ectopic pregnancy incidence rate (per 10000 person months) was 1.912 and 0.595 in the PID and control group, respectively; the rate ratio was 3.211 (confidence interval, CI = 2.931-3.519). There were significantly different in gynecologic cancers and urinary tract cancers between the PID and control group; the rate ratios (95% C.I.) were 1.903 (1.672-2.166) and 1.566 (1.211-2.025), respectively.Conclusion: Our study found that PID was associated with increased risks of gynecologic and urinary tract cancer but not colorectal or breast cancer. The information may lead to a strategy for cancer prevention and a reasonable healthcare usage through understanding PID epidemiology and controlling the inflammatory responses.

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Section: Discussionsupporting

confidence: 93%

The Risk of Gynecologic and Urinary Tract Cancer with Pelvic Inflammatory Disease: A Population-Based Cohort Study

Lin¹,

Wang²,

Lee³

et al. 2019

J. Cancer

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“…Adolescents engaging in early and unsafe sexual activities represent a high-risk population for infection with human immunodeficiency virus, other sexually transmitted diseases, and unplanned pregnancy[50]. Adolescents who experience PID are highly likely to experience adverse reproductive health outcomes [51,52]. This outcome is an important issue in the prevention of PID[51–53].…”

Section: Discussionmentioning

confidence: 99%

Association of pelvic inflammatory disease (PID) with ectopic pregnancy and preterm labor in Taiwan: A nationwide population-based retrospective cohort study

Huang

Lin

et al. 2019

PLoS ONE

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Background Pelvic inflammatory disease (PID) is an infectious disease that causes tubal occlusion and other pelvic and abdominal adhesions. The incidence of pelvic inflammatory disease (PID) has increased due to the sexually active status of the young population. This leads to a more serious problem and a larger effect than previously observed. However, there have been few studies on this topic in Asian populations. Aim We aimed to evaluate the risk of preterm labor and/or ectopic pregnancy in Taiwanese women following PID. Design Using the Taiwan National Health Insurance Database, we designed a retrospective cohort study that included 12- to 55-year-old pregnant women between 2000 and 2010. We selected a 1:3 age-matched control group of non-PID women. The endpoint was any episode of preterm labor or ectopic pregnancy; otherwise, the patients were tracked until 31 December 2010. Methods The risk factors for preterm labor or ectopic pregnancy were explored. For cases included from the index date until the end of 2010, we analyzed the risk of incident preterm labor or ectopic pregnancy. With the use of a multivariate Cox proportional hazard regression analysis, we calculated the hazard ratio (HR) with a 95% CI and compared it with that of the control group. Results This study examined 30,450 patients with PID and 91,350 controls. During the follow-up period, patients in the PID group were more likely to develop preterm labor or ectopic pregnancy than patients in the control group. The cumulative incidence rates for developing preterm labor were 1.84% (561/30,450 individuals) in patients with PID and 1.63% (1492/91,350 individuals) in patients without PID. On the other hand, the cumulative incidence rate for developing ectopic pregnancy in patients with PID was 0.05% (14/30,450 individuals) but was only 0.04% (33/91,350 individuals) in patients without PID. Compared with those without PID, the patients with PID had a 1.864 times (P<0.001) higher risk of developing preterm labor and a 2.121 times (P = 0.003) higher risk of developing ectopic pregnancy. Conclusion Our study provided evidence of an increased risk of preterm labor or ectopic pregnancy in PID patients.

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“…As Ct can ascend to the upper genital tract, serious sequalae including PID, which can lead to ectopic pregnancy (EP) and chronic pelvic pain or infertility, are commonly observed in the Australian hospital settings. Data from the past decade (2009-2014) shows increasing Ct-related PID rates [25]. A recent study examining Ct presence in testicular biopsies showed that replicating Ct is present in human testicular tissue in up to 45% detection rates and may be associated with moderate to severe spermatogenic impairment [26].…”

Section: Sexually Transmitted Ct Infections-sti Infections With No Inmentioning

confidence: 99%

Chlamydiae from Down Under: The Curious Cases of Chlamydial Infections in Australia

Jelocnik

2019

Microorganisms

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In Australia, the most researched and perhaps the most successful chlamydial species are the human pathogen Chlamydia trachomatis, animal pathogens Chlamydia pecorum and Chlamydia psittaci. C. trachomatis remains the leading cause of sexually transmitted infections in Australians and trachoma in Australian Indigenous populations. C. pecorum is globally recognised as the infamous koala and widespread livestock pathogen, whilst the avian C. psittaci is emerging as a horse pathogen posing zoonotic risks to humans. Certainly not innocuous, the human infections with Chlamydia pneumoniae seem to be less prevalent that other human chlamydial pathogens (namely C. trachomatis). Interestingly, the complete host range for C. pecorum and C. psittaci remains unknown, and infections by other chlamydial organisms in Australian domesticated and wildlife animals are understudied. Considering that chlamydial organisms can be encountered by either host at the human/animal interface, I review the most recent findings of chlamydial organisms infecting Australians, domesticated animals and native wildlife. Furthermore, I also provide commentary from leading Australian Chlamydia experts on challenges and future directions in the Chlamydia research field.

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Rates of pelvic inflammatory disease and ectopic pregnancy in Australia, 2009–2014: ecological analysis of hospital data

Abstract: PID and EP remain important causes of hospital admissions for female STI-associated complications. Hospital EDs care for more PID cases than inpatient departments, particularly for young women. Updated primary care data are needed to better understand PID epidemiology and healthcare usage.

Cited by 17 publications

References 26 publications

The Risk of Gynecologic and Urinary Tract Cancer with Pelvic Inflammatory Disease: A Population-Based Cohort Study

The Risk of Gynecologic and Urinary Tract Cancer with Pelvic Inflammatory Disease: A Population-Based Cohort Study

Association of pelvic inflammatory disease (PID) with ectopic pregnancy and preterm labor in Taiwan: A nationwide population-based retrospective cohort study

Chlamydiae from Down Under: The Curious Cases of Chlamydial Infections in Australia

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