Claire Lo, Abin Abraham, Cosmin A Bejan, Seth A Reasoner, Mario Davidson, Loren Lipworth, David M Aronoff
{"title":"避孕暴露与育龄妇女尿路感染风险相关:一项病例对照研究。","authors":"Claire Lo, Abin Abraham, Cosmin A Bejan, Seth A Reasoner, Mario Davidson, Loren Lipworth, David M Aronoff","doi":"10.1080/13625187.2022.2156278","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Although non-barrier contraception is commonly prescribed, the risk of urinary tract infections (UTI) with contraceptive exposure is unclear.</p><p><strong>Materials and methods: </strong>Using data from Vanderbilt University Medical Centre's deidentified electronic health record (EHR), women ages 18-52 were randomly sampled and matched based on age and length of EHR. This case-control analysis tested for association between contraception exposure and outcome using UTI-positive (UTI+) as cases and upper respiratory infection+ (URI+) as controls.</p><p><strong>Results: </strong>24,563 UTI + cases (mean EHR: 64.2 months; mean age: 31.2 years) and 48,649 UTI-/URI + controls (mean EHR: 63.2 months; mean age: 31.9 years) were analysed. In the primary analysis, UTI risk was statistically significantly increased for the oral contraceptive pill (OCP; OR = 1.10 [95%CI = 1.02-1.11], <i>p</i> ≤ 0.05), intrauterine device (IUD; OR = 1.13 [95%CI = 1.04-1.23], <i>p</i> ≤ 0.05), etonogestrel implant (Nexplanon<sup>®</sup>; OR = 1.56 [95% CI = 1.24-1.96], <i>p</i> ≤ 0.05), and medroxyprogesterone acetate injectable (Depo-Provera<sup>®</sup>; OR = 2.16 [95%CI = 1.99-2.33], <i>p</i> ≤ 0.05) use compared to women not prescribed contraception. A secondary analysis that included <i>any</i> non-IUD contraception, which could serve as a proxy for sexual activity, demonstrated a small attenuation for the association between UTI and IUD (OR = 1.09 [95%CI = 0.98-1.21], <i>p</i> = 0.13).</p><p><strong>Conclusion: </strong>This study notes potential for a small increase in UTIs with contraceptive use. Prospective studies are required before this information is applied in clinical settings.</p><p><strong>Condensation: </strong>Although non-barrier contraception is commonly prescribed, the risk of urinary tract infections (UTI) with contraceptive exposure is poorly understood. This large-cohort, case-control study notes potential for a small increase in UTIs with contraceptive use.</p>","PeriodicalId":50491,"journal":{"name":"European Journal of Contraception and Reproductive Health Care","volume":"28 1","pages":"17-22"},"PeriodicalIF":1.9000,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Contraceptive exposure associates with urinary tract infection risk in a cohort of reproductive-age women: a case control study.\",\"authors\":\"Claire Lo, Abin Abraham, Cosmin A Bejan, Seth A Reasoner, Mario Davidson, Loren Lipworth, David M Aronoff\",\"doi\":\"10.1080/13625187.2022.2156278\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Although non-barrier contraception is commonly prescribed, the risk of urinary tract infections (UTI) with contraceptive exposure is unclear.</p><p><strong>Materials and methods: </strong>Using data from Vanderbilt University Medical Centre's deidentified electronic health record (EHR), women ages 18-52 were randomly sampled and matched based on age and length of EHR. This case-control analysis tested for association between contraception exposure and outcome using UTI-positive (UTI+) as cases and upper respiratory infection+ (URI+) as controls.</p><p><strong>Results: </strong>24,563 UTI + cases (mean EHR: 64.2 months; mean age: 31.2 years) and 48,649 UTI-/URI + controls (mean EHR: 63.2 months; mean age: 31.9 years) were analysed. In the primary analysis, UTI risk was statistically significantly increased for the oral contraceptive pill (OCP; OR = 1.10 [95%CI = 1.02-1.11], <i>p</i> ≤ 0.05), intrauterine device (IUD; OR = 1.13 [95%CI = 1.04-1.23], <i>p</i> ≤ 0.05), etonogestrel implant (Nexplanon<sup>®</sup>; OR = 1.56 [95% CI = 1.24-1.96], <i>p</i> ≤ 0.05), and medroxyprogesterone acetate injectable (Depo-Provera<sup>®</sup>; OR = 2.16 [95%CI = 1.99-2.33], <i>p</i> ≤ 0.05) use compared to women not prescribed contraception. A secondary analysis that included <i>any</i> non-IUD contraception, which could serve as a proxy for sexual activity, demonstrated a small attenuation for the association between UTI and IUD (OR = 1.09 [95%CI = 0.98-1.21], <i>p</i> = 0.13).</p><p><strong>Conclusion: </strong>This study notes potential for a small increase in UTIs with contraceptive use. Prospective studies are required before this information is applied in clinical settings.</p><p><strong>Condensation: </strong>Although non-barrier contraception is commonly prescribed, the risk of urinary tract infections (UTI) with contraceptive exposure is poorly understood. This large-cohort, case-control study notes potential for a small increase in UTIs with contraceptive use.</p>\",\"PeriodicalId\":50491,\"journal\":{\"name\":\"European Journal of Contraception and Reproductive Health Care\",\"volume\":\"28 1\",\"pages\":\"17-22\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Contraception and Reproductive Health Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/13625187.2022.2156278\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Contraception and Reproductive Health Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/13625187.2022.2156278","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Contraceptive exposure associates with urinary tract infection risk in a cohort of reproductive-age women: a case control study.
Purpose: Although non-barrier contraception is commonly prescribed, the risk of urinary tract infections (UTI) with contraceptive exposure is unclear.
Materials and methods: Using data from Vanderbilt University Medical Centre's deidentified electronic health record (EHR), women ages 18-52 were randomly sampled and matched based on age and length of EHR. This case-control analysis tested for association between contraception exposure and outcome using UTI-positive (UTI+) as cases and upper respiratory infection+ (URI+) as controls.
Results: 24,563 UTI + cases (mean EHR: 64.2 months; mean age: 31.2 years) and 48,649 UTI-/URI + controls (mean EHR: 63.2 months; mean age: 31.9 years) were analysed. In the primary analysis, UTI risk was statistically significantly increased for the oral contraceptive pill (OCP; OR = 1.10 [95%CI = 1.02-1.11], p ≤ 0.05), intrauterine device (IUD; OR = 1.13 [95%CI = 1.04-1.23], p ≤ 0.05), etonogestrel implant (Nexplanon®; OR = 1.56 [95% CI = 1.24-1.96], p ≤ 0.05), and medroxyprogesterone acetate injectable (Depo-Provera®; OR = 2.16 [95%CI = 1.99-2.33], p ≤ 0.05) use compared to women not prescribed contraception. A secondary analysis that included any non-IUD contraception, which could serve as a proxy for sexual activity, demonstrated a small attenuation for the association between UTI and IUD (OR = 1.09 [95%CI = 0.98-1.21], p = 0.13).
Conclusion: This study notes potential for a small increase in UTIs with contraceptive use. Prospective studies are required before this information is applied in clinical settings.
Condensation: Although non-barrier contraception is commonly prescribed, the risk of urinary tract infections (UTI) with contraceptive exposure is poorly understood. This large-cohort, case-control study notes potential for a small increase in UTIs with contraceptive use.
期刊介绍:
The Official Journal of the European Society of Contraception and Reproductive Health, The European Journal of Contraception and Reproductive Health Care publishes original peer-reviewed research papers as well as review papers and other appropriate educational material.