Objective: To investigate associations between a history of induced abortion and current or previous sexually transmitted diseases and other gynecologic infections.
Methods: A cohort study was performed at two family planning clinics and one youth clinic. Of 996 women, 192 (19.3%) admitted a history of induced abortion, whereas the remaining 804 women served as a control group. A structured, personal interview which included details on previous genital infections and gynecologic symptoms and a gynecologic examination was performed. Genital chlamydial infection, gonorrhea, genital herpes, genital warts, cervical human papillomavirus infection, bacterial vaginosis, candidiasis, and bacteria associated with bacterial vaginosis were diagnosed.
Results: Both a history of genital infections, with the exception of vulvovaginal candidiasis, and current genital symptoms were more common in women with a history of induced abortion, compared with the control group. Age-adjusted odds ratios ranged from 1.5 (history of genital warts, 95% confidence interval (95% CI 0.9-2.5) to 5.0 (history of gonorrhea, 95% CI 2.6-9.7). Odds ratios for current bacterial vaginosis was 1.9 (95% CI 1.2-2.9) and for vulvovaginal candidiasis 1.8 (95% CI 1.1-2.7).
Conclusion: Women attending a clinic for an induced abortion could be a target group for sexually transmitted disease information programs.
PIP: This study examines the relationship between a history of induced abortion and current or previous sexually transmitted diseases (STDs) and other gynecologic symptoms. Study participants consisted of a cohort of women attending 2 family planning and 1 youth clinic; 192 were admitted with history of induced abortion and 804 women served as controls. A structured interview to obtain data on previous genital infections and gynecologic symptoms was conducted and gynecologic examination was performed. Various types of STDs and gynecologic symptoms were diagnosed including chlamydial infection, gonorrhea, genital herpes, genital warts, cervical human papillomavirus infection, bacterial vaginosis, candidiasis, and bacterial vaginosis. The study found a high frequency of gynecologic symptoms in women with history of induced abortion such as abnormal vaginal discharges, pruritus, genital malodor, deep dyspareunia and urinary symptoms. Moreover, a history of gonorrhea, genital chlamydial infection, genital warts, and genital herpes were 1.5-5 times more common among women who experienced induced abortion. As a consequence of the 3-fold increase in the history of STDs, the study found a 4-fold increase of a history of pelvic inflammatory disease in women with induced abortion history. Considering these findings, women attending clinics for induced abortions could be a good target population for STD information programs and campaigns.