Predictors of chronic pelvic pain in an urban population of women with symptoms and signs of pelvic inflammatory disease.
OBJECTIVE
The objective of this study was to assess the risk profile for chronic pelvic pain (CPP) after pelvic inflammatory disease (PID).


METHODS
Multivariate logistic regression was used to assess risk factors for CPP in a longitudinal study of 780 predominately black, urban women with clinically suspected PID: complaints of acute pain (<30 days); a clinical finding of pelvic tenderness; and leukorrhea, mucopurulent cervicitis, or untreated gonococcal or chlamydial cervicitis. CPP was defined as pain reported at >or=2 consecutive interviews conducted every 3 to 4 months for 2 to 5 years.


RESULTS
Nonblack race (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.31-3.58), being married (OR, 2.06; 95% CI, 1.02-4.18), a low SF-36 mental health composite score (OR, 2.71; 95% CI, 1.69-4.34), >or=2 prior PID episodes (OR, 2.84; 95% CI, 1.07-7.54), and smoking (OR, 1.65; 95% CI, 1.01-2.71) independently predicted CPP. Histologic endometritis or evidence of endometrial Neisseria gonorrhoeae or Chlamydia trachomatis infection was negatively associated with CPP (OR, 0.69; 95% CI, 0.44-1.10).


CONCLUSIONS
A range of demographic, clinical, historical, and behavioral factors predict CPP after PID.
Haggerty
Catherine L
CL
University of Pittsburgh, Department of Epidemiology, Pittsburgh, Pennsylvania 15261, USA.
Peipert
Jeffrey F
JF
Weitzen
Sherry
S
Hendrix
Susan L
SL
Holley
Robert L
RL
Nelson
Deborah B
DB
Randall
Hugh
H
Soper
David E
DE
Wiesenfeld
Harold C
HC
Ness
Roberta B
RB
D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D010147:Pain Measurement; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology / Q000517:prevention & control; D017699:Pelvic Pain / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014504:Urban Health; D044465:White People / Q000706:statistics & numerical data; D016387:Women's Health; D001741:Black or African American