经产妇盆腔炎的流行病学，特别提及宫内节育器的使用情况。

Buchan H, Villard-Mackintosh L, Vessey M, Yeates D, McPherson K

Department of Public Health and Primary Care, Radcliffe Infirmary, Oxford.

Br J Obstet Gynaecol. 1990 Sep;97(9):780-8. doi: 10.1111/j.1471-0528.1990.tb02571.x.

Up to the end of 1989, 206 parous women in the Oxford Family Planning Association contraceptive study had been referred to hospital with a first episode of pelvic inflammatory disease. Of these, 65 suffered from definite disease described as acute, 81 from definite disease not described as acute and 60 from 'other disease'. Considering all forms of disease together, referral was less common in those aged 25-29 and in those aged 45 or more than in those aged 30-44. Referral was more common in those of low social class, in those who smoked and in those who married young. All these factors were taken into account in analyses considering the effects of contraceptive methods. In these analyses, women currently using the contraceptive pill, the diaphragm, the sheath, female sterilization or an intrauterine device (IUCD) were compared with those currently using other methods or no method of contraception. IUCD ex-users were, however, placed in a separate category, irrespective of their current method of contraception. The relative risks obtained in these analyses, with 95% CI, were as follows: contraceptive pill 0.5 (0.2-0.9), diaphragm 0.6 (0.3-1.2), sheath 1.2 (0.6-2.4), female sterilization 0.7 (0.3-1.5), non-medicated IUCD 3.3 (2.3-5.0), medicated IUCD 1.8 (0.8-4.0), IUCD ex-users 1.3 (0.7-2.3). These data suggest that oral contraceptives, the diaphragm and female sterilization protect against pelvic inflammatory disease and that IUCDs increase the risk. Medicated devices, however, appear to carry only about half the risk of non-medicated devices, and the elevation of risks in IUCD ex-users appears to be small. Special analyses examined the risk associated with use of a Dalkon Shield. Among women currently using an IUCD (of any kind), those who had used a Dalkon Shield (at any time) had nearly five times as great a risk of hospital referral for pelvic inflammatory disease as those who had never used a Dalkon Shield (relative risk 4.7, 95% CI 2.1-9.0).

截至1989年底，牛津计划生育协会避孕研究中的206名经产妇因盆腔炎首次发作被转诊至医院。其中，65人患有明确的急性疾病，81人患有明确的非急性疾病，60人患有“其他疾病”。综合考虑所有疾病形式，25至29岁以及45岁及以上人群的转诊情况比30至44岁人群少见。社会阶层较低、吸烟以及早婚人群的转诊更为常见。在分析避孕方法的影响时，考虑了所有这些因素。在这些分析中，将目前使用避孕药、子宫托、避孕套、女性绝育术或宫内节育器（IUCD）的女性与目前使用其他方法或未采取避孕措施的女性进行了比较。然而，IUCD的既往使用者被归为一个单独的类别，无论她们目前的避孕方法是什么。这些分析得出的相对风险及95%置信区间如下：避孕药0.5（0.2 - 0.9），子宫托0.6（0.3 - 1.2），避孕套1.2（0.6 - 2.4），女性绝育术0.7（0.3 - 1.5），无药IUCD 3.3（2.3 - 5.0），含药IUCD 1.8（0.8 - 4.0），IUCD既往使用者1.3（0.7 - 2.3）。这些数据表明，口服避孕药、子宫托和女性绝育术可预防盆腔炎，而IUCD会增加患病风险。然而，含药装置的风险似乎仅约为无药装置的一半，IUCD既往使用者的风险升高似乎较小。专门分析研究了与使用达康盾相关的风险。在目前使用IUCD（任何类型）的女性中，曾使用过达康盾（在任何时间）的女性因盆腔炎被转诊至医院的风险几乎是从未使用过达康盾女性的五倍（相对风险4.7，95%置信区间2.1 - 9.0）。