Contraception, legal abortion and genital Chlamydia trachomatis
in 19-year-old women from an urban Swedish population
I. Lindh1, F. Blohm1, D.
Höglund2, K. Stenqvist2, A. Andersson-Ellström1, I. Milsom1
1Department of Obstetrics
& Gynecology, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden,
2Dept of Communicable Disease Control, Göteborg, Sweden
Background At present
there are few studies relating the prevalence of diffferent contraceptive
techniques to the occurrence of genital Chlamydia trachomatis infections and
legal abortions.
Objectives To compare contraceptive use and the incidence of
genital Chlamydia infections and legal abortions in 19-year old women in 1991
and 2001.
Material and methods The use of contraception and possible pregnacies
was assessed by a postal questionnaire distributed to random samples of
19-year-old women resident in the city of Göteborg in 1991 (n = 780) and 2001
(n= 666). The number of genital Chlamydia infections among 19-year old women
resident in the city of Göteborg in 1991 and 2001 was obtained from the
Department of
Communicable Disease Control.
Results The questionnaire was completed by 641
women (82%) in 1991 and by 514 women in 2001 (77%). The self-reported percentage
frequency of non-use of contraception had decreased in 2001 compared with 1991
(38% to 22%). There was a small increase in the use of combined oral
contraceptives (35% to 37%), a somewhat greater increase in the use of condom
alone (14% to 24%) and a reduction in the use of combined oral contraceptives
plus condom (12% to 10%) between 1991 and 2001. During the same period there was
a 28% reduction in legal abortions (cumulative incidence < 19 years down from 99.8/1000 women in 1991 to 37/1000 women in 2001) and a 29% increase in genital
Chlamydia infections (incidence up from 32.5/1000 women in 1991 to 42.0/1000
women in 2001).
Conclusions There was a favourable trend regarding
contraceptive usage and the incidence of legal abortions among 19-year old women
between 1991 and 2001. In contrast to these positive findings there was an
increase in the incidence of Chlamydia infections during the same time period
despite the reported increased use of condoms.