Risk Factors for Endometritis and Incident Infection: a Secondary Data Analysis of the T Cell Response Against Chlamydia (TRAC) Study

Objective: Assess risk factors for incident and endometrial infection and determine if is associated with histological endometritis, an indicator of pelvic inflammatory disease.

Methods: This study was a secondary data analysis within the T cell Response Against Chlamydia (TRAC) Study, a prospective evaluation of 246 women with or at risk for from urban outpatient clinics, who were followed quarterly for 12 months. Risk factors for incident infection were determined by Cox regression. Relative risks were estimated by Poisson regression with robust error measurements for models examining the association between and endometritis (histological evidence of plasma cells in endometrial stroma and neutrophils in the endometrial epithelium) and for models examining risk factors for detection of endometrial infection.

Results: prevalence was 16.7%, incidence was 25.3 per 100 person-years and 23% had repeated positive tests. Black race (non-black HR 0.4, 95% CI 0.2 to 0.9), less education (HR 2.4, 95% CI 1.2 to 5.1) and a new sexual partner (HR 3.1, 95% CI 1.7 to 5.4) were associated with incident was associated with endometritis (RR 2.0, 95% CI 1.1 to 3.7). (RR 2.0, 95% CI 1.2 to 3.4) and endometrial (RR 1.7, 95% CI 1.1 to 2.8) were associated with endometrial .

Conclusions: is prevalent in women at high risk for , persists over multiple follow-up visits and is associated with histological endometritis. Studies are needed to determine if screening for will improve reproductive outcomes.