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Lb3.258 Rates of pelvic inflammatory disease and ectopic pregnancy are no longer declining: an ecological analysis of australian hospital admissions and emergency presentation data, 2009–2014
  1. Jane L Goller1,
  2. Alysha De Livera1,
  3. Rebecca J Guy2,
  4. Nicola Low3,
  5. Basil Donovan2,
  6. Mathew Law2,
  7. John Kaldor2,
  8. Christopher K Fairley4,
  9. Jane S Hocking1
  1. 1Melbourne School of Population And Global Health, University of Melbourne, Parkville, Australia
  2. 2Kirby Institute, Unsw, Sydney, Australia
  3. 3University of Bern, Bern, Switzerland
  4. 4Central Clinical School, Monash University And Melbourne Sexual Health Centre, Melbourne, Australia

Abstract

Introduction Pelvic inflammatory disease (PID) and ectopic pregnancy (EP) among women are important sequelae of sexually transmissible infections (STIs). We assessed recent trends in these STI-related morbidities in three Australian states (Victoria, New South Wales, Queensland).

Methods Hospital admission and emergency presentation PID and EP rates among women 15–44 years were extracted and analysed by residential postcode for 2009–2014 using population and live birth denominators where relevant. Final data were available in 2017. Zero Inflated Poisson (ZIP) models were used to assess variation in rates by year, age, socio-economic disadvantage and area of residence. A sub-analysis of acute and/or STI-confirmed PID admissions was undertaken.

Results Admission and emergency presentation rates respectively per 1 00 000 women in 2014 were: i) 63.3 (95%CI: 60.8–65.9) and 97.0 (95%CI: 93.9–100.2) for PID; and ii) 107.8 (95%CI: 104.5–111.2) and 96.7 (95%CI: 93.6–99.9) for EP. Of all emergency cases, 68% of PID and 22% of EP were managed without admission. PID admission rates did not change by year, but acute/STI-confirmed PID admissions increased by 40% between 2009 and 2014 (Incidence rate ratio [IRR]: 1.4; 95% CI: 1.2–1.7). Emergency PID rates increased by 30% between 2009 and 2014 (IRR: 1.3; 95% CI: 1.2–1.5). PID admission and emergency rates were highest among women 15–24 years. Population based EP rates increased by 10% in emergency between 2009 and 2014 (IRR: 1.1; 95% CI: 1.1–1.2). EP rates per 1000 live births increased by 8% (IRR: 1.08; 95% CI: 1.06–1.11) for admissions and 27% (IRR: 1.27; 95% CI: 1.21–1.33) for emergency between 2009 and 2014. Increasing disadvantage and remoteness of area tended to be associated with higher PID and EP rates.

Conclusion These data show that, for the first time in two decades, STI-related sequelae diagnoses at Australian hospitals are increasing.

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