title: Adverse adolescent reproductive health outcomes after pelvic inflammatory disease.
abstract: OBJECTIVE
  To compare longitudinal adolescent and adult reproductive outcomes after pelvic inflammatory disease (PID).
  
  
  METHODS
  Secondary analysis of longitudinal data from the Pelvic Inflammatory Disease Evaluation and Clinical Health study.
  
  
  METHODS
  A large multicenter randomized clinical trial assessing PID treatment strategies in the United States.
  
  
  METHODS
  Eight hundred thirty-one female patients aged 14 to 38 years with a diagnosis of PID.
  
  
  METHODS
  Adverse longitudinal outcomes were compared in adolescents (≤19 years) and adults (>19 years).
  
  
  METHODS
  Primary outcome measures included recurrent sexually transmitted infection at 30 days, recurrent PID, chronic abdominal pain, infertility, pregnancy, and times to recurrent PID and pregnancy. Cox proportional hazards modeling was used to examine the effect of young age on times to pregnancy and recurrent PID.
  
  
  RESULTS
  Adolescents were more likely than adults to have positive results of sexually transmitted infection testing at baseline and at 30 days. There were no significant group differences in chronic abdominal pain, infertility, and recurrent PID at 35 or 84 months, but adolescents were more likely to have a pregnancy at both time points. Adjusted hazard ratios (95% confidence intervals) also demonstrated that adolescents had shorter times to pregnancy (1.48 [1.18-1.87]) and recurrent pelvic inflammatory disease (1.54 [1.03-2.30]).
  
  
  CONCLUSIONS
  Adolescents may require a different approach to clinical care and follow-up after PID to prevent recurrent sexually transmitted infections, recurrent PID, and unwanted pregnancies.
authors.affiliation: Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. mtrent2@jhmi.edu
authors.forename: Maria
authors.initials: M
authors.lastname: Trent
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Haggerty
authors.forename: Jacky M
authors.initials: JM
authors.lastname: Jennings
authors.forename: Sunghee
authors.initials: S
authors.lastname: Lee
authors.forename: Debra C
authors.initials: DC
authors.lastname: Bass
authors.forename: Roberta
authors.initials: R
authors.lastname: Ness
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007247:Infertility, Female / Q000175:diagnosis* / Q000453:epidemiology; D008137:Longitudinal Studies; D000292:Pelvic Inflammatory Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012008:Recurrence; D012016:Reference Values; D018456:Reproductive Medicine; D018570:Risk Assessment; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D013997:Time Factors; D014481:United States; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents