衣原体感染史对女性妊娠和备孕时间的影响。
Pregnancies and Time to Pregnancy in Women With and Without a Previous Chlamydia trachomatis Infection.
机构信息
From the Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven.
Department of Genetics and Cell Biology, Research School GROW (School for Oncology and Developmental Biology), Faculty of Health, Medicine and Life Sciences, University of Maastricht, Maastricht.
出版信息
Sex Transm Dis. 2020 Nov;47(11):739-747. doi: 10.1097/OLQ.0000000000001247.
BACKGROUND
A Chlamydia trachomatis infection (chlamydia) can result in tubal factor infertility in women. To assess if this association results in fewer pregnant women, we aimed to assess pregnancy incidences and time to pregnancy among women with a previous chlamydia infection compared with women without one and who were participating in the Netherlands Chlamydia Cohort Study (NECCST).
METHODS
The NECCST is a cohort of women of reproductive age tested for chlamydia in a chlamydia screening trial between 2008 and 2011 and reinvited for NECCST in 2015 to 2016. Chlamydia status (positive/negative) was defined using chlamydia screening trial-nucleic acid amplification test results, chlamydia immunoglobulin G presence in serum, or self-reported chlamydia infections. Data on pregnancies were collected via questionnaires in 2015-2016 and 2017-2018. Overall pregnancies (i.e., planned and unplanned) and time to pregnancy (among women with a pregnancy intention) were compared between chlamydia-positive and chlamydia-negative women using Cox regressions.
RESULTS
Of 5704 women enrolled, 1717 (30.1%; 95% confidence interval [CI], 28.9-31.3) women was chlamydia positive. Overall pregnancy proportions were similar in chlamydia-positive and chlamydia-negative women (49.0% [95% CI, 46.5-51.4] versus 50.5% [95% CI, 48.9-52.0]). Pregnancies per 1000 person-years were 53.2 (95% CI, 51.5-55.0) for chlamydia negatives and 83.0 (95% CI, 78.5-87.9) for chlamydia positives. Among women with a pregnancy intention, 12% of chlamydia-positive women had a time to pregnancy of >12 months compared with 8% of chlamydia negatives (P < 0.01).
CONCLUSIONS
Overall pregnancy rates were not lower in chlamydia-positive women compared with chlamydia-negative women, but among women with a pregnancy intention, time to pregnancy was longer and pregnancy rates were lower in chlamydia-positive women.
TRIAL REGISTRATION NUMBER
Dutch Trial Register NTR-5597.
背景
沙眼衣原体感染（衣原体）可导致女性输卵管因素不孕。为了评估这种关联是否会导致孕妇减少，我们旨在评估与未感染衣原体的女性相比，之前感染过衣原体的女性的妊娠发生率和妊娠时间，这些女性参加了荷兰衣原体队列研究（NECCST）。
方法
NECCST 是一项生育年龄女性队列研究，她们在 2008 年至 2011 年期间参加了衣原体筛查试验，并在 2015 年至 2016 年期间被重新邀请参加 NECCST。衣原体状态（阳性/阴性）使用衣原体筛查试验-核酸扩增试验结果、血清中存在的衣原体免疫球蛋白 G 或自我报告的衣原体感染来定义。2015-2016 年和 2017-2018 年通过问卷调查收集妊娠数据。使用 Cox 回归比较衣原体阳性和衣原体阴性女性之间的总妊娠（即计划和非计划）和妊娠时间（对于有妊娠意向的女性）。
结果
在纳入的 5704 名女性中，1717 名（30.1%；95%置信区间[CI]，28.9-31.3）女性衣原体阳性。衣原体阳性和衣原体阴性女性的总妊娠比例相似（49.0%[95%CI，46.5-51.4]与 50.5%[95%CI，48.9-52.0]）。衣原体阴性者每 1000 人年的妊娠率为 53.2（95%CI，51.5-55.0），衣原体阳性者为 83.0（95%CI，78.5-87.9）。在有妊娠意向的女性中，12%的衣原体阳性女性的妊娠时间超过 12 个月，而衣原体阴性者为 8%（P<0.01）。
结论
与衣原体阴性女性相比，衣原体阳性女性的总妊娠率没有降低，但在有妊娠意向的女性中，衣原体阳性女性的妊娠时间更长，妊娠率更低。
试验注册号
荷兰试验注册 NTR-5597。
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