Association of pelvic inflammatory disease (PID) with ectopic pregnancy and preterm labor in Taiwan: A nationwide population-based retrospective cohort study

• Published in: PloS one Vol. 14; no. 8; p. e0219351
• Main Authors: Huang, Chun-Chung, Huang, Chien-Chu, Lin, Shao-Yi, Chang, Cherry Yin-Yi, Lin, Wu-Chou, Chung, Chi-Hsiang, Lin, Fu-Huang, Tsao, Chang-Huei, Lo, Chun-Min, Chien, Wu-Chien
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 13.08.2019; Public Library of Science (PLoS)
• Subjects: Adhesions; Adolescent; Adult; Antibiotics; Biomedical engineering; Case-Control Studies; Child; Clinical trials; Cohort analysis; Communicable diseases; Complications and side effects; Design; Disease; Disease susceptibility; Ectopic pregnancy; Female; Gynecology; Health; Hospitals; Humans; Incidence; Infections; Infectious diseases; Inflammatory diseases; Insurance; Labor; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; National health insurance; Obstetric Labor, Premature - epidemiology; Obstetric Labor, Premature - etiology; Obstetrics; Occlusion; Pelvic inflammatory disease; Pelvic Inflammatory Disease - complications; People and Places; Population studies; Population-based studies; Pregnancy; Pregnancy complications; Pregnancy, Ectopic - epidemiology; Pregnancy, Ectopic - etiology; Pregnant women; Premature birth; Premature labor; Proportional integral derivative; Public health; Regression analysis; Retrospective Studies; Risk analysis; Risk Factors; Sexual behavior; Social Sciences; Statistics; Studies; Taiwan - epidemiology; Women; Womens health; Young Adult; Taiwan; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0219351

Pelvic inflammatory disease (PID) is an infectious disease that causes tubal occlusion and other pelvic and abdominal adhesions. The incidence of pelvic inflammatory disease (PID) has increased due to the sexually active status of the young population. This leads to a more serious problem and a larger effect than previously observed. However, there have been few studies on this topic in Asian populations. We aimed to evaluate the risk of preterm labor and/or ectopic pregnancy in Taiwanese women following PID. Using the Taiwan National Health Insurance Database, we designed a retrospective cohort study that included 12- to 55-year-old pregnant women between 2000 and 2010. We selected a 1:3 age-matched control group of non-PID women. The endpoint was any episode of preterm labor or ectopic pregnancy; otherwise, the patients were tracked until 31 December 2010. The risk factors for preterm labor or ectopic pregnancy were explored. For cases included from the index date until the end of 2010, we analyzed the risk of incident preterm labor or ectopic pregnancy. With the use of a multivariate Cox proportional hazard regression analysis, we calculated the hazard ratio (HR) with a 95% CI and compared it with that of the control group. This study examined 30,450 patients with PID and 91,350 controls. During the follow-up period, patients in the PID group were more likely to develop preterm labor or ectopic pregnancy than patients in the control group. The cumulative incidence rates for developing preterm labor were 1.84% (561/30,450 individuals) in patients with PID and 1.63% (1492/91,350 individuals) in patients without PID. On the other hand, the cumulative incidence rate for developing ectopic pregnancy in patients with PID was 0.05% (14/30,450 individuals) but was only 0.04% (33/91,350 individuals) in patients without PID. Compared with those without PID, the patients with PID had a 1.864 times (P<0.001) higher risk of developing preterm labor and a 2.121 times (P = 0.003) higher risk of developing ectopic pregnancy. Our study provided evidence of an increased risk of preterm labor or ectopic pregnancy in PID patients.