Prevalence of Pelvic Inflammatory Disease in Sexually Experienced Women of Reproductive Age - United States, 2013-2014

Abstract

Pelvic inflammatory disease (PID) is a clinical syndrome of the female reproductive tract characterized by inflammation of the endometrium, fallopian tubes, or peritoneum (1). PID occurs when microorganisms ascend from the vagina or cervix to the fallopian tubes and other upper genital tract structures (1). PID can result from untreated bacterial infections, including chlamydia and gonorrhea, and can lead to infertility, ectopic pregnancy, and chronic pelvic pain (1). Because there is no single diagnostic test for PID, clinicians rely on nonspecific signs and symptoms for diagnosis. The purpose of these analyses was to assess the burden of self-reported PID in a nationally representative sample using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2014 cycle. Starting in 2013, NHANES female participants aged 18-44 years were asked about a lifetime history of PID diagnosis. Based on these data, the estimated prevalence of self-reported lifetime PID was 4.4% in sexually experienced women of reproductive age (18-44 years). The prevalence of self-reported lifetime PID was highest in women at increased risk, such as women reporting a previous sexually transmitted infection (STI) diagnosis. Stratified by race/ethnicity and having a previous STI diagnosis, non-Hispanic black (black) and non-Hispanic white (white) women reporting a previous STI diagnosis had nearly equal self-reported lifetime PID prevalence (10.0% versus 10.3%). However, the lifetime prevalence of PID among black women was 2.2 times that among white women if no previous STI was diagnosed (6.0% versus 2.7%). These findings suggest that PID is prevalent and associated with previous STI diagnoses; therefore, it is important for clinicians to screen female patients for chlamydia and gonorrhea to reduce the incidence of PID.

FIGURE

Prevalence of self-reported lifetime pelvic inflammatory disease* among sexually experienced women^† aged 18–44 years (n = 1,171), by race/ethnicity and previous STI diagnosis^§,¶ — National Health and Nutrition Examination Survey, United States, 2013–2014 Abbreviation: STI = sexually transmitted infection. * Prevalence estimates based on response to the question, “Have you ever been treated for an infection in your fallopian tubes, uterus or ovaries, also called a pelvic infection, pelvic inflammatory disease, or PID?” Estimates were weighted to be nationally representative of the U.S. population, accounting for unequal probabilities of selection and nonresponse. ^† Based on a response of “Yes” to the question, “Have you ever had vaginal, anal, or oral sex?” ^§ Participants who were told by a doctor or other health care professional in the last 12 months that they had chlamydia or gonorrhea or were ever told they have herpes, human papilloma virus, or genital warts. ^¶ Bars indicate 95% confidence interval. Prevalence estimates among non- Hispanic black women with a previous STI diagnosis have a relative standard error >40% but <50%.