THE IMPACT OF ORAL CONTRACEPTION ON CHLAMYDIAL INFECTION AMONG PATIENTS WITH PELVIC INFLAMMATORY DISEASE

The prevalence of oral contraceptive use in association with chlamydia l pelvic inflammatory disease (PID) and the presence of anti-chlamydia l IgG and IgA in a population of 144 hospitalized and outpatient subje cts with a standard diagnosis of PID was studied. The rates of chlamyd ial PID and IgA detection were 15.3% (22/144) and 13.9% (20/144), resp ectively. After stratification for age, number of pregnancies, and Lif etime sexual partners, the rates of chlamydial PID (odds ratio = 0.30, 95% CI = 0.10 -0.89) and IgA detection (odds ratio = 0.23, 95% CI = 0 .07 -0.73) were lower among previous or current oral contraceptive use rs than in women who had never used birth control methods. Analyses of linear trend indicated a negative association between increasing dura tion of exposure to hormonal contraception and anti-chlamydial IgG and IgA. This study confirms that among patients with chlamydial PID, the frequency of oral contraceptive use is lower than that in patients wi th PID of other etiology. Serologic studies suggest a possible relatio nship between hormonal contraception and changes in immune response or susceptibility to chlamydial infection. (C) 1996 Elsevier Science Inc .