Few long-term studies reporting incidence and behavioral data for Chlamydia trachomatis (CT) infection in the general population have been published. Such studies are important to understand risk factors associated with infection and to develop screening recommendations. A fixed prospective 4-year cohort study of 898 sexually active Norwegian women, aged 16 to 23 years at study start, was conducted to assess incidence, repeat infection, and risk factors associated with genital CT infection. Participants were interviewed at study start and at 6-month intervals thereafter for behavioral characteristics. The women were tested for CT infection at 12-month intervals beginning at study start. Risk factors were assessed using Fisher exact test and conditional logistic regression. Person-time was estimated in survival analyses and incidence of CT infection was reported as events per 100 woman-years. Median duration of observation was 48.0 months (range 10-74) whereas 4.4 specimens were collected per woman (range 2-5). Of the 836 women eligible for the analysis, 19 (2.2%) had a prevalent infection at baseline. The 4-year cumulative incidence of CT infection was 7.7 (95% CI: 6.7-8.7) with annual incidences ranging from 1.2 to 2.9 per 100 woman-years. The 2-year cumulative incidence of repeat CT infection was 11.2 (95% CI: 9.3-13.1) per 100 woman-years. In multivariate analyses, factors associated with incident CT infection were young age (< or =24 years) and number of new partners over the last 12 months prior being tested. The annual incidences observed for women 24 years or younger with 1 or more new partners over the last 12 months support recommendations for annual testing for CT in this age group in Norway.

Objectives The objective of this study was to quantify the cost burden of unintended pregnancies (UPs) in Norway, and to estimate the proportion of costs due to imperfect contraceptive adherence. Potential cost savings that could arise from increased uptake of long-acting reversible contraception (LARC) were also investigated. Methods An economic model was constructed to estimate the total number of UPs and associated costs in women aged 15–24 years. Adherence-related UP was estimated using ‘perfect use’ and ‘typical use’ contraceptive failure rates. Potential savings from increased use of LARC were projected by comparing current costs to projected costs following a 5% increase in LARC uptake. Results Total costs from UP in women aged 15–24 years were estimated to be 164 million Norwegian Kroner (NOK), of which 81.7% were projected to be due to imperfect contraceptive adherence. A 5% increase in LARC uptake was estimated to generate cost savings of NOK 7.2 million in this group. Conclusions The cost of UP in Norway is substantial, with a large proportion of this cost arising from imperfect contraceptive adherence. Increased LARC uptake may reduce the UP incidence and generate cost savings for both the health care payer and contraceptive user.

Appropriate antenatal care (ANC) utilization has direct, significant effects on perinatal mortality (PM). Georgia has one of the highest PM rates (11.7 per 1000 births) in Europe and launched a more intensive ANC programme in 2018. To evaluate the associations between the Adequacy of Prenatal Care Utilization (APNCU) index and neonatal intensive care unit (NICU) admission and PM in Georgia. The Georgian Birth Registry (GBR), with linkage to the Vital Registration System, was used as the main data source; 148,407 eligible mothers and singleton newborns were identified during the observation period (2017–2019). The main exposure was ANC utilization, measured by the APNCU index, and the hospitalization registry was used to validate NICU admissions. Logistic regression analysis was used to assess the associations between the exposure and outcomes while controlling for potential confounders. The overall PM rate was 11.6/1000 births, and the proportion of newborns with a NICU admission was 7.8%. 85% of women initiated ANC before gestational age week 12. According to the APNCU index, 16% of women received inadequate, 10% intermediate, 38% adequate, and 36% intensive care. Women who received intermediate care had the lowest odds of PM (adjusted odds ratio [AOR] = 0.56, 95% confidence interval [CI] 0.45–0.70), and newborns of women who received inadequate care had the highest odds of NICU admission (AOR = 1.16, 95% CI 1.09–1.23) and PM (AOR = 1.18, 95% CI 1.02–1.36). ANC utilization is significantly associated with newborn asmissions to NICU and PM in Georgia. Women received inadequate care experienced the highest odds of newborn admissions to NICU and PM.

Objective. To investigate quality of life (QoL) among women reporting urinary incontinence (UI). Design. Population‐based cross‐sectional study. Setting. Survival status for all women who had primary treatment between 1987 and 1996 at the University Hospital, Trondheim, Norway, was assessed in 2003. Eligible for study participation were recurrence‐free survivors of gynecological cancer and age‐matched women selected from the general population. Methods. Women who had no history of gynecological cancer were selected as age‐matched controls in a 4:1 ratio to survivors in the population census. In 2004, all eligible participants were sent an extensive questionnaire. After one reminder the response rate was 55% (176/319) and 41% (521/1276) for survivors and controls, respectively. UI (total, stress, urge and mixed) was in agreement with definitions of the International Continence Society. QoL was measured by Ferrans and Powers’ Quality of Life Index (QLI). The chi‐squared test for categorical variables, unpaired T‐test for continuous variables and logistic regression were applied. Results. A history of recurrence‐free gynecologic cancer was not associated with reduced QLI. The prevalence of UI was 34.5%. Women with UI had lower scores on total QLI and all domains (health/functioning, psychological/spiritual, socio‐economic, and family domain) compared with continent women. A decreasing score of QLI and its domains were found for increasing severity of UI. After adjustment for other co‐morbidities UI remained an independent significant predictor of QLI below the 25. percentile, but not for QLI below the 10. percentile. Conclusion. UI has a negative impact on QoL. The more severe UI, the more reduced were total and all QLI domains.

To investigate the impact of intrauterine devices on subsequent fertility. Intrauterine devices are safe, well tolerated and used by millions of women worldwide. Subsequent fertility is studied among women who remove the intrauterine contraceptive device for planning pregnancy or among women who have removed the intrauterine contraceptive device because of intrauterine contraceptive device-related complications and later on have become pregnant. Study participants are recruited from randomized clinical trials on intrauterine contraceptive device performance or in case series among women who remove the intrauterine contraceptive device. Pregnancy rates after removal are high and are similar to time-to-pregnancy rates in the general population. The birth rates are high with a normal distribution of preterm deliveries, normal birth weight and sex ratio of newborns. The ratio of extra-intrauterine pregnancies and the need for infertility work up are low, and the distribution of infertility causes among fully investigated couples is as seen in the general population. Despite small sample size of studies investigating impact of intrauterine contraceptive devices on subsequent fertility, the results are consistent and reassuring on high pregnancy rates, and a normal distribution of pregnancy outcomes. There are limited data on return of fertility after usage of medicated intrauterine contraceptive devices--more studies are warranted among women who have used hormone-releasing intrauterine contraceptive devices.