TY - JOUR
T1 - A prospective study of risk factors for symptomatic urinary tract infection in young women
AU - Hooton, Thomas M.
AU - Scholes, Delia
AU - Hughes, James P.
AU - Winter, Carol
AU - Roberts, Pacita L.
AU - Stapleton, Ann E.
AU - Stergachis, Andy
AU - Stamm, Walter E.
N1 - Copyright:
Copyright 2007 Elsevier B.V., All rights reserved.
PY - 1996/8/15
Y1 - 1996/8/15
N2 - Background: Although acute urinary tract infections are common in young women, the associated risk factors have not been defined prospectively. Methods: We recruited sexually active young women who were starting a new method of contraception at a university health center or a health maintenance organization (HMO) and monitored them for six months for symptomatic urinary tract infections. Daily diaries and serial interviews were used to collect data on potential risk factors. Results: Among 796 women, the incidence of urinary tract infections per person-year was 0.7 in the university cohort (mean age, 23 years; n = 348) and 0.5 in the HMO cohort (mean age, 29; n = 448). In both cohorts, there were strong dose-response relations between the risk of infection and both recent use of a diaphragm with spermicide (respective relative risks for one, three, and five days of use in the past week, 1.42, 2.83, and 5.68 in the university cohort, P<0.001; and 1.29, 2.14, and 3.54 in the HMO cohort, P = 0.04) and recent sexual intercourse (respective relative risks for one, three, and five days with intercourse in the past week, 1.37, 2.56, and 4.81 in the university cohort, P<0.001; and 1.24, 1.91, and 2.96 in the HMO cohort, P = 0.002). The risk of acute infection was also associated with a history of recurrent infection (relative risk, 5.58 in the university cohort and 2.10 in the HMO cohort) but not with cervical-cap use, ABO-blood-group nonsecretor phenotype, or delayed postcoital voiding. Conclusions: Among sexually active young women the incidence of symptomatic urinary tract infection is high, and the risk is strongly and independently associated with recent sexual intercourse, recent use of a diaphragm with spermicide, and a history of recurrent urinary tract infections.
AB - Background: Although acute urinary tract infections are common in young women, the associated risk factors have not been defined prospectively. Methods: We recruited sexually active young women who were starting a new method of contraception at a university health center or a health maintenance organization (HMO) and monitored them for six months for symptomatic urinary tract infections. Daily diaries and serial interviews were used to collect data on potential risk factors. Results: Among 796 women, the incidence of urinary tract infections per person-year was 0.7 in the university cohort (mean age, 23 years; n = 348) and 0.5 in the HMO cohort (mean age, 29; n = 448). In both cohorts, there were strong dose-response relations between the risk of infection and both recent use of a diaphragm with spermicide (respective relative risks for one, three, and five days of use in the past week, 1.42, 2.83, and 5.68 in the university cohort, P<0.001; and 1.29, 2.14, and 3.54 in the HMO cohort, P = 0.04) and recent sexual intercourse (respective relative risks for one, three, and five days with intercourse in the past week, 1.37, 2.56, and 4.81 in the university cohort, P<0.001; and 1.24, 1.91, and 2.96 in the HMO cohort, P = 0.002). The risk of acute infection was also associated with a history of recurrent infection (relative risk, 5.58 in the university cohort and 2.10 in the HMO cohort) but not with cervical-cap use, ABO-blood-group nonsecretor phenotype, or delayed postcoital voiding. Conclusions: Among sexually active young women the incidence of symptomatic urinary tract infection is high, and the risk is strongly and independently associated with recent sexual intercourse, recent use of a diaphragm with spermicide, and a history of recurrent urinary tract infections.
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U2 - 10.1056/NEJM199608153350703
DO - 10.1056/NEJM199608153350703
M3 - Article
C2 - 8672152
AN - SCOPUS:0029739053
VL - 335
SP - 468
EP - 474
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 7
ER -