title: Increasing chlamydia diagnoses but little change in hospitalisations for ectopic pregnancy and infertility among women in New South Wales from 2001 to 2008.
abstract: BACKGROUND
  As genital chlamydia (Chlamydia trachomatis) notifications have increased in Australia, time trends in hospitalisations for ectopic pregnancy and female infertility between 2001 and 2008 in New South Wales (NSW), Australia, and their relationship to trends in chlamydia notifications in women were assessed.
  
  
  METHODS
  Annual rates of chlamydia notification, and hospitalisations for female infertility or ectopic pregnancy in women aged 15-44 years in NSW were calculated using routinely collected data. Chlamydia notifications and hospital separations occurring within each year belonging to the same woman were linked using probabilistic linkage of identifiers so that multiple notifications and admissions for one woman in each calendar year were only counted once.
  
  
  RESULTS
  From 2001 to 2008, the annual rate of chlamydia diagnoses in women increased from 157 to 477 per 100000 population (P(trend)<0.001). Over the same period, the annual hospitalisation rate for women with an ectopic pregnancy decreased from 14.3 to 12.6 per 1000 births (P(trend)<0.001). This decrease was mostly in women aged 25-44 years, with no appreciable fall in women aged 15-24 years (P(trend)=0.8). Meanwhile, the hospitalisation rate for women with infertility of female origin did not follow a consistent trend: between 2001 and 2008, it fluctuated between a low of 479 and a high of 554 per 10000 women who were seeking pregnancy.
  
  
  CONCLUSIONS
  These trends in ectopic pregnancy and female infertility suggest that the large increase in chlamydia notifications may not reflect hospitalisations for these two proposed chlamydia-related sequelae.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia. Bliu@kirby.unsw.edu.au
authors.forename: Bette
authors.initials: B
authors.lastname: Liu
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
authors.forename: Jim
authors.initials: J
authors.lastname: Parker
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guy
authors.forename: Jane
authors.initials: J
authors.lastname: Hocking
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.forename: Handan
authors.initials: H
authors.lastname: Wand
authors.forename: Louisa
authors.initials: L
authors.lastname: Jorm
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology*; D018563:Disease Notification / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology*; D008498:Medical Record Linkage; D009517:New South Wales / Q000453:epidemiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology*