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Improving reproductive long-term prognosis for women with a first ectopic pregnancy. A national controlled follow-up
Pia Egerup1, Line Lund Kårhus, Charlotte Wessel Skovlund
1Department of Gynecology, Rigshospitalet University Hospital, University of Copenhagen, Copenhagen, Denmark.
Objective:
To describe developments in reproductive long-term prognosis in women with a first ectopic pregnancy as compared with two control cohorts.
Design:
Controlled cohort study.
Setting:
Data were collected from four national Danish registries.
Population:
All Danish women of reproductive age (15-49 years) through the period 1977-2009 and all reproductive outcomes in these women.
Methods:
Data were collected from four national Danish registries. Three cohorts of women with a first recorded ectopic pregnancy during the periods 1980-84, 1985-89, and 1990-94, were compared with age-matched controls with a first miscarriage and a first induced abortion and followed for 15 years for all further pregnancy outcomes.
Main Outcome Measures:
Pregnancy outcomes included deliveries, miscarriages, induced abortions and ectopic pregnancies.
Results:
The birth rate for women with a first ectopic pregnancy increased significantly through the three cohorts from 85 to 122 deliveries/100 women during the follow-up period. The risk of miscarriages also increased over time, whereas the risk of further ectopic pregnancies remained unchanged at 22-24 events/100 women. Compared to women with a first miscarriage, the rate ratio for deliveries increased from 0.59 (95% CI 0.56-0.63) to 0.71 (95% CI 0.68-0.75) over the time covering the three cohorts.
Conclusion:
The long-term delivery rate among women with a first ectopic pregnancy has improved significantly over time.
