Chlamydia trachomatis and oral contraceptive use: a quantitative review

Area of Science:

• Epidemiology
• Public Health
• Infectious Diseases

Background:

• Chlamydia trachomatis is a significant sexually transmitted disease.
• Oral contraceptive use is increasing globally, especially in developing nations.
• Previous studies suggest a link between oral contraceptive use and higher rates of C. trachomatis infection.

Purpose of the Study:

• To evaluate the association between oral contraceptive use and Chlamydia trachomatis infection.
• To synthesize findings from published studies between 1972 and 1990.

Main Methods:

• Meta-analysis of prospective and case-control studies.
• Pooled estimation of unadjusted odds ratios.
• Subgroup analysis based on study quality, C. trachomatis prevalence, and contraceptive comparison.

Main Results:

• A pooled odds ratio of 1.93 indicated nearly a twofold increased risk of chlamydial infection for oral contraceptive users.
• This increased risk was consistent across studies regardless of quality or prevalence.
• The risk increased to 2.91 when oral contraceptives were compared to barrier methods, which showed a protective effect (OR=0.34).

Conclusions:

• The association between oral contraceptive use and increased chlamydial infection risk is supported by available evidence.
• Limitations include potential confounding factors like sexual behavior and age in component studies.
• Promoting barrier methods is crucial due to their demonstrated protective effect against STDs.