Contraceptive exposure associates with urinary tract infection risk in a cohort of reproductive-age women: a case control study

Abstract

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.

摘要

目的：虽然非屏障避孕很常用, 但使用避孕药后发生尿路感染（urinary tract infections, UTI）的风险尚不明确。

材料和方法：使用范德堡大学医学中心的去识别化的电子健康记录（electronic health record, EHR）数据, 根据EHR的长度和年龄, 对18～52岁的女性进行随机抽样和匹配。本病例对照分析以UTI阳性（UTI+）为例, 以上呼吸道感染阳性（upper respiratory infection+, URI+）为对照, 检验了避孕药暴露与结局之间的相关性。

结果：分析了24563例UTI+患者（平均HER：64.2个月；平均年龄：31.2岁）和48649例UTI-/URI+对照患者（平均HER：63.2个月；年龄：31.9岁）。在初步分析中, 以下因素显著增加了UTI的风险：口服避孕药（oral contraceptive pill, OCP; OR = 1.10, 95%CI: 1.02-1.11, p ≤ 0.05）、宫内节育器（intrauterine device, IUD; OR = 1.13, 95%CI: 1.04-1.23, p ≤ 0.05）、依托孕烯植埋剂（Nexplanon^®; OR = 1.56, 95% CI: 1.24-1.96, p ≤ 0.05）和醋酸甲羟孕酮注射液（Depo-Provera^®; OR=2.16, 95%CI: 1.99-3.33, p≤0.05）。一项包括任何非IUD避孕措施的二次分析表明, UTI与IUD之间的关联性略有减弱（OR=1.09, 95%CI: 0.98-1.21, p=0.13）。

结论：这项研究注意到使用避孕药后尿路感染风险可能稍增加。在应用于临床之前, 尚需要进行前瞻性研究。

简略总结：尽管非屏障避孕很常用, 但使用避孕药物后发生UTI的风险尚不明确。这项大型队列、病例对照研究发现, 使用避孕药物后, UTI风险可能稍增加。

Keywords:

• Urinary tract infection
• contraception
• electronic health record
• case control study

Disclosure statement

No potential conflict of interest was reported by the author(s).