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Article
March 25, 1988

Risk Factors for Ectopic Pregnancy: A Population-Based Study

Author Affiliations

From the Division of Reproductive Health, Centers for Disease Control, Atlanta (Dr Marchbanks); the School of Public Health, Division of Epidemiology, University of Texas Health Science Center, Houston (Dr Annegers); the Methodist Center for Reproduction and Transplantation Immunology, Indianapolis (Dr Coulam); the Park Nicollet Medical Center, St Louis Park, Minn (Dr Strathy); and the Department of Medical Statistics and Epidemiology, Mayo Clinic, Rochester, Minn (Dr Kurland). Dr Marchbanks is now with the Division of Injury Epidemiology and Control, Centers for Disease Control, Atlanta.

From the Division of Reproductive Health, Centers for Disease Control, Atlanta (Dr Marchbanks); the School of Public Health, Division of Epidemiology, University of Texas Health Science Center, Houston (Dr Annegers); the Methodist Center for Reproduction and Transplantation Immunology, Indianapolis (Dr Coulam); the Park Nicollet Medical Center, St Louis Park, Minn (Dr Strathy); and the Department of Medical Statistics and Epidemiology, Mayo Clinic, Rochester, Minn (Dr Kurland). Dr Marchbanks is now with the Division of Injury Epidemiology and Control, Centers for Disease Control, Atlanta.

JAMA. 1988;259(12):1823-1827. doi:10.1001/jama.1988.03720120027030
Abstract

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.

(JAMA 1988;259:1823-1827)

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