Sexually Transmitted Diseases

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Sexually Transmitted Diseases:
doi: 10.1097/01.olq.0000187205.67390.d1
Article

Prediction of Pelvic Inflammatory Disease Among Young, Single, Sexually Active Women

Ness, Roberta B. MD, MPH*; Smith, Kenneth J. MD†; Chang, Chung-Chou H. PhD†; Schisterman, Enrique F. PhD‡; Bass, Debra C. MS*; for the Gynecologic Infection Follow-Through (GIFT) Investigators

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Abstract

Objectives: To assess prediction strategies for pelvic inflammatory disease (PID).

Study Design: One thousand one hundred seventy women were enrolled based on a high chlamydial risk score. Incident PID over a median of 3 years was diagnosed by either histologic endometritis or Centers for Disease Control and Prevention criteria. A multivariable prediction model for PID was assessed.

Results: Women enrolled using the risk score were young, single, sexually active, and often had prior sexually transmitted infections. Incident PID was common (8.6%). From 24 potential predictors, significant factors included age at first sex, gonococcal/chlamydial cervicitis, history of PID, family income, smoking, medroxyprogesterone acetate use, and sex with menses. The model correctly predicted 74% of incident PID; in validation models, correct prediction was only 69%.

Conclusions: Our data validate a modified chlamydial risk factor scoring system for prediction of PID. Additional multivariable modeling contributed little to prediction. Women identified by a threshold value on the chlamydial risk score should undergo intensive education and screening.

© Copyright 2006 American Sexually Transmitted Diseases Association

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