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Background   Chlamydia trachomatis  is a highly prevalent sexually transmitted disease. Testing rates among young Norwegian women are high. Young women diagnosed with  C. trachomatis  are often worried about future complications.    Methods  Our cohort consisted of 24,947 women born 1970–1984 who were tested for  C. trachomatis  infection during 1990–2005. We linked  C. trachomatis  laboratory data to data on hospitalizations for pelvic inflammatory disease during 1990–2005. Cox regression analysis with time-dependent covariates adjusted for age at first test was used to assess the association between  C. trachomatis  history and pelvic inflammatory disease.    Results  Follow-up until the end of 2005 included 201,387 woman-years. The incidence rate of hospitalization for pelvic inflammatory disease was higher among women with prior  C. trachomatis  infection than among women with negative tests only (48 events during 32,057 person-years and 143 events during 169,192 person-years, corresponding to 0.15 and 0.08 per 100 person-years, respectively). The corresponding hazard ratio adjusted for age at first test was 1.69 (95% CI, 1.21–2.36).    Conclusion  Our data show a link between a diagnosis of  C. trachomatis  infection and subsequent pelvic inflammatory disease. However, pelvic inflammatory disease was a rare event irrespective of  C. trachomatis  status. These, together with other recent findings, can be used to reassure women worried about their future reproductive health following a diagnosis of  C. trachomatis .

Incidence of pelvic inflammatory disease in a large cohort of women tested for Chlamydia trachomatis: a historical follow-up study