Bakken Inger J
Department of Epidemiology, SINTEF Health Research, Trondheim, Norway.
Curr Opin Infect Dis. 2008 Feb;21(1):77-82. doi: 10.1097/QCO.0b013e3282f3d972.
Genital Chlamydia trachomatis is common among young, sexually active people. Infections are most often asymptomatic but have potential long-term consequences for female reproductive health. The link between C. trachomatis and ectopic pregnancy is mainly based on early seroepidemiological case-control studies including women who had their sexual debut at a time at which testing was sparse. The purpose of the present review is to summarize recent findings in C. trachomatis and ectopic pregnancy epidemiology.
The number of prevalence studies is high but results are specific for the setting in which the study was conducted. High prevalences are often found among adolescents and young adults. At the same time, decreased ectopic pregnancy rates are reported. Registry studies from the Scandinavian countries have shown low ectopic pregnancy rates among women tested for C. trachomatis and diverging results considering whether women are at increased risk following infection.
Recent studies on C. trachomatis infection and ectopic pregnancy are few. The recent Scandinavian registry studies include women with diagnosed, and hence presumably treated, infections. The observation of low complication rates in these studies cannot be used as an argument against the importance of screening for C. trachomatis infections.
生殖道沙眼衣原体感染在性活跃的年轻人中很常见。感染通常无症状,但对女性生殖健康有潜在的长期影响。沙眼衣原体与异位妊娠之间的联系主要基于早期血清流行病学病例对照研究,这些研究纳入了在检测尚不普遍时开始有性行为的女性。本综述的目的是总结沙眼衣原体与异位妊娠流行病学的最新研究结果。
患病率研究数量众多,但结果因研究开展的背景而异。青少年和年轻人中的患病率通常较高。与此同时,异位妊娠率有所下降。斯堪的纳维亚国家的登记研究表明,接受沙眼衣原体检测的女性中异位妊娠率较低,且对于感染后女性风险是否增加存在不同结果。
近期关于沙眼衣原体感染与异位妊娠的研究较少。最近斯堪的纳维亚的登记研究纳入了已确诊感染(因此可能已接受治疗)的女性。这些研究中观察到的低并发症率不能用作反对筛查沙眼衣原体感染重要性的论据。