Elsevier

Obstetrics & Gynecology

Volume 98, Issue 6, December 2001, Pages 1117-1123
Obstetrics & Gynecology

Chlamydial infection and unplanned pregnancy in women with ready access to health care1 ,

https://doi.org/10.1016/S0029-7844(01)01576-9Get rights and content

Abstract

OBJECTIVE

To apply urine-based ligase chain reaction for Chlamydia trachomatis (C. trachomatis) and Neisseria gonorrhoeae (N. gonorrhoeae) detection and standard urine-based pregnancy testing for Navy-enlisted women, and to compare the prevalence and epidemiologic correlates of these adverse reproductive outcomes.

METHODS

Participants were surveyed and urine was collected for pregnancy testing using standard laboratory methods and detection of C. trachomatis and N. gonorrhoeae infection by ligase chain reaction. Self-administered surveys facilitated collection of demographics, sexual behavior, including contraceptive use, sexual partners, sexually transmitted disease, and pregnancy history.

RESULTS

Among 299 of 314 participants, the prevalence of chlamydial infection was 4.7% and of pregnancy was 9.7%, with 48.3% of the pregnancies unplanned. Chlamydia trachomatis infection was univariately associated with having a new sex partner within the last 6 months, more sexual partners, single marital status, condom use, drinking until passing out or vomiting in the past 30 days (alcohol misuse), and current pregnancy. Unplanned pregnancy was univariately associated with young age, single marital status, inconsistent condom use, having a new sex partner within the last 6 months, and more recent sexual partners. Among the pregnant women, four (13.8%) were infected with C. trachomatis.

CONCLUSION

The high rates of chlamydial infection and unplanned pregnancy found in this population of employed young women with ready access to health care and health education underscore the challenge of enhancing reproductive health via compliance with effective contraceptive and sexually transmitted disease prevention methods. This is a challenge that remains unmet.

Section snippets

Materials and methods

Of 600 eligible Navy-enlisted women, 314 (52.3%) were voluntarily enrolled in October 1995 from a shore-based command (131 of 150; 87%) and a ship-based submarine tender (183 of 450; 41%). Nonavailability, because of work assignments or leave during briefing and enrollment periods, was the primary reason for nonparticipation. There were no significant differences between the demographic characteristics and work site assignments of participants and nonparticipants.

All participants signed a

Results

The demographics, risk characteristics, and risk exposures of the 299 participants included in the data analysis are summarized in Table 1. The women were generally young, and the majority were white. Approximately half of the population was single and all had completed high school, with 42.3% having at least some post-high school vocational or college education. Two of the women reported they had not “ever had sex” and were thus excluded from analysis of current sexual behavior. Of the

Discussion

In this cross-sectional study of healthy young women in the Navy, we report prevalent adverse reproductive outcomes of asymptomatic chlamydial infection and unplanned pregnancy in 8.7% of the population. Chlamydia trachomatis infection, detected in 4.7% of the participants, was multivariably associated with current pregnancy and misuse of alcohol. Unplanned pregnancy, found in nearly half of the pregnancies, was univariably associated with single marital status, younger age, having new partners

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  • Cited by (0)

    This work was supported by the United States Army Medical Research and Material Command, MIRR No. 95MM5525 and Naval Health Research Center Work Unit No. 6434.

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    Disclaimer: The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.

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