Predictors of Chronic Pelvic Pain in an Urban Population of Women With Symptoms and Signs of Pelvic Inflammatory Disease

In Brief Objective: The objective of this study was to assess the risk profile for chronic pelvic pain (CPP) after pelvic inflammatory disease (PID). Study: Multivariate logistic regression was used to assess risk factors for CPP in a longitudinal study of 780 predominately black, urban women with clinically suspected PID: complaints of acute pain (<30 days); a clinical finding of pelvic tenderness; and leukorrhea, mucopurulent cervicitis, or untreated gonococcal or chlamydial cervicitis. CPP was defined as pain reported at ≥2 consecutive interviews conducted every 3 to 4 months for 2 to 5 years. Results: Nonblack race (odds ratio [OR], 2.17; 95% confidence interval [CI], 1.31–3.58), being married (OR, 2.06; 95% CI, 1.02–4.18), a low SF-36 mental health composite score (OR, 2.71; 95% CI, 1.69–4.34), ≥2 prior PID episodes (OR, 2.84; 95% CI, 1.07–7.54), and smoking (OR, 1.65; 95% CI, 1.01–2.71) independently predicted CPP. Histologic endometritis or evidence of endometrial Neisseria gonorrhoeae or Chlamydia trachomatis infection was negatively associated with CPP (OR, 0.69; 95% CI, 0.44–1.10). Conclusions: A range of demographic, clinical, historical, and behavioral factors predict CPP after PID. A longitudinal analysis of 780 women with pelvic inflammatory disease (PID) found that nonblack race, being married, a low SF-36 mental health composite score, ≥2 prior pelvic inflammatory disease episodes, and smoking predict chronic pelvic pain (CPP). Histologic endometritis and Neisseria gonorrhoeae/Chlamydia trachomatis were negatively associated with CPP.