A retrospective cohort study examining STI testing and perinatal records demonstrates reproductive health burden of chlamydia and gonorrhea.

Adverse reproductive health outcomes, such as pelvic inflammatory disease, ectopic pregnancy, and tubal factor infertility, have been associated with Chlamydia trachomatis and Neisseria gonorrhoea infections. These reproductive health outcomes could be complemented by measuring subsequent pregnancies to assess impact on fertility. The study design was a cohort study of women in Queensland (QLD), Australia, using data linkage methods to link chlamydia and/or gonorrhea testing records (including an unexposed group undergoing full blood count tests) (2000 and 2005) with the QLD Perinatal Registry (2000 to 2013). The cohort included 132 962 women, with 69 533 records of pregnancies. Women in the exposed group, with no prior pregnancy, had a reduced odds of a pregnancy during the follow up of the study (20 year old (at 2005) aOR 0.91 95% CI 0.87-0.95, and 25 year old aOR 0.71 95% CI 0.68-0.75). Women in the exposed group with a prior pregnancy had increased odds of pregnancy during the follow up of the study (20 year old (at 2005) aOR 1.72 95% CI 1.59-1.86, and 25 year old aOR 1.35 95% CI 1.26-1.45). Our data provides further evidence at a population level of the significant impact on reproductive outcomes associated with chlamydia and gonorrhea.