1. Screening for chlamydial infections and the risk of ectopic pregnancy in a county in Sweden: ecological analysis
- Author
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Matthias Egger, Nicola Low, Björn Herrmann, George Davey Smith, and Bo Lindblom
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,Chlamydia trachomatis ,medicine.disease_cause ,Uterine Cervical Diseases ,Age Distribution ,Pregnancy ,Risk Factors ,CHLAMYDIAL INFECTIONS ,medicine ,Humans ,Mass Screening ,Sex organ ,Pregnancy Complications, Infectious ,Ecological analysis ,Risk factor ,Mass screening ,General Environmental Science ,Sweden ,Gynecology ,Chlamydia ,Ectopic pregnancy ,Obstetrics ,business.industry ,Outcome measures ,General Engineering ,Obstetrics and Gynecology ,General Medicine ,Chlamydia Infections ,medicine.disease ,Pregnancy, Ectopic ,Papers ,Regression Analysis ,General Earth and Planetary Sciences ,Gestation ,Female ,business ,Contact tracing ,Chlamydial infection - Abstract
Objectives: To analyse trends in rates of genital chlamydial infection and ectopic pregnancy between 1985 and 1995 in a county in Sweden. Setting: Uppsala county where screening for chlamydial infection, treatment, and contact tracing has been widespread and where ectopic pregnancies are recorded. Methods: Rates of chlamydial infections and ectopic pregnancy between 1985 and 1995 were calculated for women aged 20-39 years. Poisson and linear regression were used to examine the association between the risk of ectopic pregnancy and the current rates of chlamydial infection and rates of chlamydial infection from up to 5 years earlier. Main outcome measures: Rates of chlamydial infection per 100 examinations, rates of ectopic pregnancy per 1000 pregnancies, rate ratios and 95% confidence intervals for an increase in chlamydial infections of 5 new cases per 100 examinations. Results: 103 870 cervical samples from women aged 15-39 years were analysed; 5648 (5.4%) were positive for chlamydia. 51 630 pregnancies were analysed; 930 (1.8%) were ectopic. Both rates declined over time. For women aged 20-24 years there was a strong correlation between the rate of ectopic pregnancy and the rate of chlamydial infection in the same year (r=0.93, P Conclusions: Declining rates of genital chlamydial infections have probably led to a fall in the rate of ectopic pregnancies. The timing of the decline in the rate of ectopic pregnancies varies with age. Among young women falling rates of chlamydial infection have been accompanied by an immediate reduction in the rate of ectopic pregnancy. Key messages The effect of measures to diagnose and treat genital chlamydial infections on the risk of ectopic pregnancy was examined in a county in Sweden Rates of chlamydial infection and ectopic pregnancy both declined between 1985 and 1995 Chlamydial infections seem to be the main cause of ectopic pregnancy in young women; the risk of ectopic pregnancy decreased concurrently with the decline in chlamydial infections In older women the associations were less pronounced
- Published
- 1998