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Long-term sequelae of acute pelvic inflammatory disease. A retrospective cohort study
S Safrin1, J Schachter, D Dahrouge
1Department of Medicine, University of California, San Francisco.
Objective:
Our objective was to prospectively assess the frequency and predictors of long-term sequelae of acute pelvic inflammatory disease.
Study Design:
We performed a retrospective cohort study of 140 women admitted for treatment of pelvic inflammatory disease to San Francisco General Hospital in 1985, locating and interviewing 51 women by telephone a median of 37 months later.
Results:
Twelve (24%) women had pelvic pain for 6 months or more after hospitalization, 22 (43%) had subsequent episode(s) of pelvic inflammatory disease, and 40% were involuntarily infertile. A history of pelvic inflammatory disease prior to admission was associated with infertility (p = 0.05), chronic pelvic pain (p = 0.03), and pelvic inflammatory disease subsequent to hospitalization (p = 0.06). Longer duration of abdominopelvic pain before admission and younger age at the time of first sexual intercourse were associated with both infertility (p = 0.02, p = 0.04) and subsequent pelvic inflammatory disease (p = 0.04, p = 0.0008).
Conclusions:
Further studies are needed to more accurately assess the incidence and predictors of long-term sequelae of pelvic inflammatory disease. A reduction in adverse outcome will require more stringent efforts at education and reduction of risk-taking behaviors.