Global burden and trends of ectopic pregnancy: An observational trend study from 1990 to 2019

Abstract

Background Ectopic pregnancy (EP) is one of the leading causes of death in women in early pregnancy, and the mortality of EP have gradually decreased over time in developed countries such as the United Kingdom and the United States. However, epidemiological information on EP has been lacking in recent years, so we analyzed EP data over a thirty-year period from 1990–2019 with the help of Global Burden of Disease study (GBD) data to fill this gap. Methods According to the EP data in GBD for the three decades from 1990 to 2019, we used estimated annual percentage changes (EAPC) to assess the trend of age-standardized incidence rate (ASIR), age-standardized death rate (ASDR) and age-standardized disability adjusted life years (AS-DALYs) trends in EP and to explore the correlation between socio-demographic index (SDI) stratification, age stratification and EP. Results Global ASIR, ASDR, AS-DALYs for EP in 2019 are 170.33/100,000 persons (95% UI: 133.18 to 218.49), 0.16/100,000 persons (95% UI, 0.14 to 0.19) and 9.69/100,000 persons (95% UI, 8.27 to 11.31), respectively. At the overall level, ASDR is significantly negatively correlated with SDI values (R = -0.699, p < 0.001). Besides that, ASDR and AS-DALYs have basically the same pattern. In addition, iron deficiency is one of the risk factors for EP. Conclusions In the past three decades, the morbidity, mortality and disease burden of EP have gradually decreased. It is noteworthy that some economically disadvantaged areas are still experiencing an increase in all indicators, therefore, it is more important to strengthen the protection of women from ethnic minorities and low-income groups.

Successful management of prolonged abdominal pregnancy in low-resource setting: a case report

“…EP is life-threatening for the mother especially due to the possible consequent internal hemorrhage and it represents the leading cause of maternal mortality in the first trimester, with an estimated incidence of 5–10% of all pregnancy-related deaths [ 1 ]. Reliable epidemiological data are available only in developed countries with well-established healthcare and it is estimated that EP accounts for ~2% of all pregnancies in Europe and North America [ 2 ]. On the contrary, in developing countries, due to poor medical and economic conditions, limited antenatal visits and prevention programs, not only it is difficult to find epidemiological data but there are important limitations in the understanding of the risk factors and management of EP [ 2 ].…”

“…Reliable epidemiological data are available only in developed countries with well-established healthcare and it is estimated that EP accounts for ~2% of all pregnancies in Europe and North America [ 2 ]. On the contrary, in developing countries, due to poor medical and economic conditions, limited antenatal visits and prevention programs, not only it is difficult to find epidemiological data but there are important limitations in the understanding of the risk factors and management of EP [ 2 ]. The main risk factors for EP are the use of an intrauterine device at the time of conception, Chlamydia trachomatis and Neisseria gonorrhea infections, current or past history of pelvic inflammatory disease, previous EP, iron deficiency, and smoking cigarettes [ 3 ].…”

Service Evaluation of an Early Pregnancy Loss Support Clinic in a London EPU

“…Early pregnancy loss (EPL) is de ned as a diagnosis of miscarriage or an ectopic pregnancy diagnosis before 14 weeks of gestation [1] [2]. An estimated 1 in 5 pregnancies end in miscarriage, and approximately 1 in 90 pregnancies are diagnosed as an ectopic [3] [4][1] [2], with ectopic pregnancy being the leading cause of maternal morbidity and unexpected death worldwide [5].…”