Reproductive tract complication risks following

Asymptomatic chlamydia infections Chlamydia control Chlamydia trachomatis Prospective cohort study Reproductive tract complications

Journal

The Lancet regional health. Europe
ISSN: 2666-7762
Titre abrégé: Lancet Reg Health Eur
Pays: England
ID NLM: 101777707

Informations de publication

Date de publication:
Oct 2024
Historique:
received: 22 02 2024
revised: 24 07 2024
accepted: 26 07 2024
medline: 9 9 2024
pubmed: 9 9 2024
entrez: 9 9 2024
Statut: epublish

Résumé

The clinical and public health relevance of widespread testing for asymptomatic A cohort of 5704 reproductive-age women recruited from a chlamydia screening study was followed for up to 14 years. Chlamydia positivity was determined using screening polymerase chain reaction test results, self-reported diagnoses (with/without symptoms), and chlamydia Immunoglobulin G antibodies. Outcome data (pregnancies, pelvic inflammatory disease (PID), ectopic pregnancy, and tubal factor infertility) were collected through self-completed questionnaires. Cox regression calculated adjusted hazard ratios (aHR) with confidence intervals (CI) to compare outcomes between time-updated chlamydia groups since sexual debut. During 104,612 person-years, 2103 (36.9%) women were chlamydia-positive and 3692 women (64.7%) had been pregnant at least once. Risks for PID, ectopic pregnancy and tubal factor infertility were 1.62 (95% CI 1.20-2.17), 1.84 (95% CI 1.14-2.95) and 2.75 (95% CI 1.53-4.94), compared to chlamydia-negatives. aHRs for PID after symptomatic and asymptomatic infections were 2.29 (95% CI 1.62-3.25) and 1.06 (95% CI 0.66-1.69), respectively. Incidence of PID, ectopic pregnancy and tubal factor infertility after symptomatic chlamydia infection remained low with rates per 1000 person-years of 5.8, 1.9, and 1.8, respectively. We found a significantly higher risk of PID, ectopic pregnancy and tubal factor infertility in chlamydia-positive women compared to chlamydia-negative women, although the overall incidence rates of complications remained low. Symptomatic, but not asymptomatic, chlamydia infections were associated with PID risk, suggesting the largest disease burden of complications is in this group. The Netherlands Organisation for Health Research and Development (ZonMW Netherlands) and Research Funding from the Ministry of Health, Welfare and Sports.

Sections du résumé

Background UNASSIGNED
The clinical and public health relevance of widespread testing for asymptomatic
Methods UNASSIGNED
A cohort of 5704 reproductive-age women recruited from a chlamydia screening study was followed for up to 14 years. Chlamydia positivity was determined using screening polymerase chain reaction test results, self-reported diagnoses (with/without symptoms), and chlamydia Immunoglobulin G antibodies. Outcome data (pregnancies, pelvic inflammatory disease (PID), ectopic pregnancy, and tubal factor infertility) were collected through self-completed questionnaires. Cox regression calculated adjusted hazard ratios (aHR) with confidence intervals (CI) to compare outcomes between time-updated chlamydia groups since sexual debut.
Findings UNASSIGNED
During 104,612 person-years, 2103 (36.9%) women were chlamydia-positive and 3692 women (64.7%) had been pregnant at least once. Risks for PID, ectopic pregnancy and tubal factor infertility were 1.62 (95% CI 1.20-2.17), 1.84 (95% CI 1.14-2.95) and 2.75 (95% CI 1.53-4.94), compared to chlamydia-negatives. aHRs for PID after symptomatic and asymptomatic infections were 2.29 (95% CI 1.62-3.25) and 1.06 (95% CI 0.66-1.69), respectively. Incidence of PID, ectopic pregnancy and tubal factor infertility after symptomatic chlamydia infection remained low with rates per 1000 person-years of 5.8, 1.9, and 1.8, respectively.
Interpretation UNASSIGNED
We found a significantly higher risk of PID, ectopic pregnancy and tubal factor infertility in chlamydia-positive women compared to chlamydia-negative women, although the overall incidence rates of complications remained low. Symptomatic, but not asymptomatic, chlamydia infections were associated with PID risk, suggesting the largest disease burden of complications is in this group.
Funding UNASSIGNED
The Netherlands Organisation for Health Research and Development (ZonMW Netherlands) and Research Funding from the Ministry of Health, Welfare and Sports.

Identifiants

DOI: 10.1016/j.lanepe.2024.101027 PMID: 39247903 PMC: PMC11378087
pubmed: 39247903
doi: 10.1016/j.lanepe.2024.101027
pii: S2666-7762(24)00194-7
pmc: PMC11378087
doi:

Types de publication

Journal Article

Langues

eng

Pagination

101027

Informations de copyright

© 2024 The Authors.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Zoïe W Alexiou (ZW)

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Institute for Public Health Genomics (IPHG), GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.

Bernice M Hoenderboom (BM)

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
Institute for Public Health Genomics (IPHG), GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.

Christian J P A Hoebe (CJPA)

Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.
Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health Mosa, Public Health Service South Limburg, the Netherlands.

Nicole H T M Dukers-Muijrers (NHTM)

Department of Sexual Health, Infectious Diseases, and Environmental Health, Living Lab Public Health Mosa, Public Health Service South Limburg, the Netherlands.
Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.

Hannelore M Götz (HM)

Department of Public Health, Municipal Public Health Service Rotterdam-Rijnmond, Rotterdam, the Netherlands.
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Marianne A B van der Sande (MAB)

Department Global Public Health, Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.

Henry J C de Vries (HJC)

Amsterdam UMC Location University of Amsterdam, Department of Dermatology, Amsterdam, the Netherlands.
Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands.
Center for Sexual Health, Department of Infectious Diseases, Public Health Service Amsterdam, the Netherlands.
Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.

Janneke E den Hartog (JE)

GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
Department of Obstetrics and Gynecology, Maastricht University Medical Center +, Maastricht, the Netherlands.

Servaas A Morré (SA)

Institute for Public Health Genomics (IPHG), GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands.
Dutch Chlamydia Trachomatis Reference Laboratory, Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands.
Department of Molecular and Cellular Engineering, Jacob Institute of Biotechnology and Bioengineering, Sam Higginbottom University of Agriculture, Technology and Sciences, Allahabad, India.

Birgit H B van Benthem (BHB)

Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.

Classifications MeSH