Adolescents may require different care than adults after PID
Trent M. Arch Pediatr Adolesc Med. 2011;165:49-54.
A recent study compared adolescent and adult reproductive health outcomes after pelvic inflammatory disease and found that “adolescents may require a different approach to clinical care and follow-up after pelvic inflammatory disease to prevent recurrent sexually transmitted infections, recurrent pelvic inflammatory disease and unwanted pregnancies.”
This study is a secondary analysis of longitudinal data from the Pelvic Inflammatory Disease Evaluation and Clinical Health (PEACH) study, which is a large multicenter, randomized clinical trial assessing pelvic inflammatory disease (PID) treatment strategies. The study included 831 female patients between the ages of 14 and 38 years with a diagnosis of PID. Those patients who were 19 years or younger were considered adolescents and represented 25% of the total sample size. The mean age of the adolescents was 17.9 years, and the mean age of adults was 25.3 years. Patients were otherwise demographically similar.
The study found that adolescents were more likely to have a sexually transmitted infection at baseline and at 30 days. At 35 or 84 months, there were no significant differences between the groups with regard to chronic abdominal pain, infertility and recurrent PID; however, adolescents were more likely to be pregnant at both time points and had shorter times to pregnancy and recurrent PID, although adolescents reported more consistent condom use than adults at baseline and at follow-up.
“The pregnancy finding is not surprising because previous studies have suggested that girls who perceive an impairment of their fertility are less likely to use contraception, that few adolescents diagnosed as having PID in observational trials are using contraception, and that adolescents often believe that prevention of infertility is beyond their control,” the study researchers wrote.
The CDC recommends that clinicians working with adolescents with PID “should engage in careful, developmentally appropriate, and nonjudgmental discussions aimed at reduction of high-risk behaviors.”
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