Reproductive Outcomes Following Ectopic Pregnancy: Register-based Retrospective Cohort Study

Overview

Journal PLoS Med

Specialty General Medicine

Date 2012 Jun 23

PMID 22723747

Citations 11

Authors

Sohinee Bhattacharya

David J McLernon

Amanda J Lee

Siladitya Bhattacharya

Affiliations

Soon will be listed here.

Abstract

Background: We aimed to compare reproductive outcomes following ectopic pregnancy (EP) versus livebirth, miscarriage, or termination in a first pregnancy.

Methods And Findings: A retrospective cohort study design was used. Scottish national data on all women whose first pregnancy occurred between 1981 and 2000 were linked to records of a subsequent pregnancy. The exposed cohort comprised women with an EP in their first pregnancy. There were three unexposed cohorts: women with livebirth, miscarriage, and termination of their first pregnancies. Any differences in rates of second pregnancy, livebirth, EP, miscarriage, or terminations and complications of a second ongoing pregnancy and delivery were assessed among the different exposure groups. A total of 2,969 women had an initial EP; 667,299 had a livebirth, 39,705 women miscarried, and 78,697 terminated their first pregnancies. Women with an initial EP had an increased chance of another pregnancy within 2 years (adjusted hazard ratio (AHR) 2.76 [95% CI 2.58-2.95]) or after 6 years (AHR 1.57 [95% CI 1.29-1.91]) compared to women with a livebirth. In comparison with women with an initial miscarriage, women who had an EP had a lower chance of a second pregnancy (AHR 0.53 [95% CI 0.50-0.56]). Compared to women with an initial termination, women with an EP had an increased chance of a second pregnancy (AHR 2.38 [95% CI 2.23-2.55]) within 2 years. Women with an initial EP suffered an increased risk of another EP compared to women with a livebirth (AHR 13.0 [95% CI 11.63-16.86]), miscarriage (AHR 6.07 [95% CI 4.83-7.62]), or termination (AHR 12.84 [95% CI 10.07-16.37]). Perinatal complications in a pregnancy following EP were not significantly higher than those in primigravidae or in women with a previous miscarriage or termination.

Conclusion: Women with an initial EP have a lower chance of conception than those who miscarry but an increased risk of a repeat EP in comparison with all three comparison groups. A major limitation of this study was the inability to separate women using contraception from those who were intending to conceive.

Citing Articles

Ectopic pregnancy.

Chong K, de Waard L, Oza M, van Wely M, Jurkovic D, Memtsa M Nat Rev Dis Primers. 2024; 10(1):94.

PMID: 39668167 DOI: 10.1038/s41572-024-00579-x.

Do the change in β-hCG values between the 0th and 4th days in tubal ectopic pregnancy treatment with a single-dose methotrexate (MTX) protocol predict the need for a second dose of MTX?.

Akdas Reis Y, Akay A, Ozkan M, Firatligil F, Dereli M, Kinay T Arch Gynecol Obstet. 2023; 309(6):2585-2590.

PMID: 37493778 DOI: 10.1007/s00404-023-07116-3.

Pre-eclampsia.

Dimitriadis E, Rolnik D, Zhou W, Estrada-Gutierrez G, Koga K, Francisco R Nat Rev Dis Primers. 2023; 9(1):8.

PMID: 36797292 DOI: 10.1038/s41572-023-00417-6.

High anti-Müllerian hormone (AMH) is associated with increased risks of ectopic pregnancy in women undergoing fresh embryo transfer cycle, a cohort study.

Hu K, Li S, Hunt S, Yang R, Xu H, Li R Reprod Biol Endocrinol. 2023; 21(1):18.

PMID: 36737777 PMC: 9896741. DOI: 10.1186/s12958-022-01038-6.

Pregnancy outcomes following in vitro fertilization treatment in women with previous recurrent ectopic pregnancy.

Xue Y, Tong X, Zhang H, Zhang S PLoS One. 2022; 17(8):e0272949.

PMID: 35969533 PMC: 9377625. DOI: 10.1371/journal.pone.0272949.

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