Risk factors for ectopic pregnancy in Germany: a retrospective study of 100,197 patients

Aim: The goal of this study was to identify potential risk factors for ectopic pregnancy in women followed in German gynecological practices. Methods: The present study included pregnant women diagnosed with ectopic pregnancy and pregnant women without ectopic pregnancy followed in 262 gynecological practices between January 2012 and December 2016. The effects of demographic and clinical variables on the risk of developing ectopic pregnancy were estimated using a multivariate logistic regression model. Results: This study included 3,003 women with ectopic pregnancy and 97,194 women without ectopic pregnancy. The mean age was 31.4 years (SD=5.9 years) in ectopic pregnancy patients and 31.1 years (SD=5.6 years) in non-ectopic pregnancy patients. Women aged 36-40 (OR=1.12) and 41-45 years (OR=1.46) were at a higher risk of ectopic pregnancy than women aged 31-35 years. Prior ectopic pregnancy was strongly associated with a risk of recurring ectopic pregnancy (OR=8.17). Prior genital surgery (OR=2.67), endometriosis (OR=1.51), and eight other gynecological diseases were also positively associated with ectopic pregnancy (ORs ranging from 1.19 to 2.06). Finally, there was a 1.80-fold increase in women previously diagnosed with psychiatric disorders. Conclusions: Prior ectopic pregnancy and prior genital surgery were strongly associated with ectopic pregnancy in women followed in German gynecological practices. Psychiatric diseases had an additional impact on the risk of ectopic pregnancy.