title: Recurrent chlamydial infections increase the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease.
abstract: OBJECTIVE
  We examined whether the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease increase with increasing numbers of chlamydial infections.
  
  
  METHODS
  A retrospective cohort design was used to evaluate the risks of hospitalization for ectopic pregnancy or pelvic inflammatory among 11,000 Wisconsin women who had one or more chlamydial infections between 1985 and 1992. Logistic regression was used to evaluate the strength of association between recurrent infection and sequelae.
  
  
  RESULTS
  After adjustment in multivariate analyses, we observed elevated risks of ectopic pregnancy among women who had two (odds ratio 2.1, 95% confidence interval 1.3 to 3.4) and 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 pelvic inflammatory (two infections: odds ratio 4.0, 95% confidence interval 1.6 to 9.9; three or more infections: odds ratio 6.4, 95% confidence interval 2.2 to 18.4).
  
  
  CONCLUSIONS
  A unique prevention opportunity occurs at the diagnosis of any chlamydial infection because women with subsequent recurrences are at increased risk for reproductive sequelae.
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Hillis
authors.forename: L M
authors.initials: LM
authors.lastname: Owens
authors.forename: P A
authors.initials: PA
authors.lastname: Marchbanks
authors.forename: L F
authors.initials: LF
authors.lastname: Amsterdam
authors.forename: W R
authors.initials: WR
authors.lastname: Mac Kenzie
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002690:Chlamydia Infections / Q000150:complications* / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D000292:Pelvic Inflammatory Disease / Q000453:epidemiology* / Q000382:microbiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology* / Q000382:microbiology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors