To evaluate the association between ectopic pregnancy and 22 potential risk factors, we conducted a population-based case-control study. The investigation included 274 cases diagnosed from 1935 through 1982 in residents of Rochester, Minn, and 548 matched controls selected from live-birth deliveries. Risk factor information documented prior to the last index menstrual period was obtained via medical record abstract. Univariate matched analyses revealed nine variables associated with a significantly elevated relative risk of ectopic pregnancy. Following conditional logistic regression, four variables remained as strong and independent risk factors for ectopic pregnancy: current intrauterine device use (relative risk, 13.7; 95% confidence interval, 1.6 to 120.6), a history of infertility (relative risk, 2.6; 95% confidence interval, 1.6 to 4.2), a history of pelvic inflammatory disease (relative risk, 3.3; 95% confidence interval, 1.6 to 6.6), and prior tubal surgery (relative risk, 4.5; 95% confidence interval, 1.5 to 13.9). Theoretically, any condition that prevents or retards migration of the fertilized ovum to the uterus could predispose a woman to ectopic gestation. Further research is needed to clarify the impact of other potential risk factors in the etiology of ectopic pregnancy.
Marchbanks PA, Annegers JF, Coulam CB, Strathy JH, Kurland LT. Risk Factors for Ectopic Pregnancy: A Population-Based Study. JAMA. 1988;259(12):1823–1827. doi:10.1001/jama.1988.03720120027030
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