Chlamydial infection and unplanned pregnancy in women with ready access tohealth care

OBJECTIVE: To apply urine-based ligase chain reaction for Chlamydia trachom atis (C trachomatis) and Neisseria gonorrhoeae (N. gonorrhoeae) detection a nd standard urine-based pregnancy testing for Navy-enlisted women, and to c ompare the prevalence and epidemiologic correlates of these adverse reprodu ctive outcomes. METHODS: Participants were surveyed and urine was collected for pregnancy t esting using standard laboratory methods and detection of C trachomatis and N. gonorrhoeae infection by ligase chain reaction. Self-administered surve ys facilitated collection of demographics, sexual behavior, including contr aceptive use, sexual partners, sexually transmitted disease, and pregnancy history. RESULTS: Among 299 of 314 participants, the prevalence of chlamydial infect ion was 4.7% and of pregnancy was 9.7%, with 48.3% of the pregnancies unpla nned. Chlamydia trachomatis infection was univariately associated with havi ng a new sex partner within the last 6 months, more sexual partners, single marital status, condom use, drinking until passing out or vomiting in the past 30 days (alcohol misuse), and current pregnancy. Unplanned pregnancy w as univariately associated with young age, single marital status, inconsist ent condom use, having a new sex partner within the last 6 months, and more recent sexual partners. Among the pregnant women, four (13.8%) were infect ed with C trachomatis. CONCLUSION: The high rates of chlamydial infection and unplanned pregnancy found in this population of employed young women with ready access to healt h care and health education underscore the challenge of enhancing reproduct ive health via compliance with effective contraceptive and sexually transmi tted disease prevention methods. This is a challenge that remains unmet. (O bstet Gynecol 2001;98:1117-23. (C) 2001 by the American College of Obstetri cians and Gynecologists.).