RECURRENT CHLAMYDIAL INFECTIONS INCREASE THE RISKS OF HOSPITALIZATIONFOR ECTOPIC PREGNANCY AND PELVIC INFLAMMATORY DISEASE

OBJECTIVE: We examined whether the risks of hospitalization for ectopi c pregnancy and pelvic inflammatory disease increase with increasing n umbers of chlamydial infections. STUDY DESIGN: A retrospective cohort design was used to evaluate the risks of hospitalization for ectopic p regnancy or pelvic inflammatory among 11,000 Wisconsin women who had o ne or more chlamydial infections between 1985 and 1992. Logistic regre ssion was used to evaluate the strength of association between recurre nt infection and sequelae. RESULTS: After adjustment in multivariate a nalyses, we observed elevated risks of ectopic pregnancy among women w ho had had two (odds ratio 2.1, 95% confidence interval 1.3 to 3.4) an d three or more chlamydial infections (odds ratio 4.5, 95% confidence interval 1.8 to 5.3). These groups were also at increased risk for pel vic inflammatory (two infections: odds ratio 4.0, 95% confidence inter val 1.6 to 9.9; three or more infections: odds ratio 6.4, 95% confiden ce interval 2.2 to 18.4). CONCLUSIONS: A unique prevention opportunity occurs at the diagnosis of any chlamydial infection because women wit h subsequent recurrences are at increased risk for reproductive sequel ae.