Risk factors associated with ectopic pregnancy: A case control study.

Abstract

Introduction: Ectopic pregnancy (EP) accounting for 10% of all pregnancies is a major health problem for women of childbearing age and leading cause of maternal deaths. The identified risk factors are previous ectopic pregnancy, previous pelvic surgery, induction of ovulation, intrauterine device usage, history of pelvic inflammatory disease, and smoking at the time of conception.
 Objective: To identify risk factor for ectopic pregnancy so that appropriate directional strategies may be developed to reduce its prevalence. 
 Methodology: This observational case control study was conducted with sample size of 100 (50 cases, 50 control) from January 2017 to 30 July 2017 at different hospitals of Sindh and Punjab. For this study, case was defined as a pregnant woman with a confirmed tubal ectopic gestation, while control as pregnant women with a confirmed normal intrauterine pregnancy. Information regarding demographic socio-economic status and risk factors were also collected.
 Results: The case & control groups were almost similar with respect to age, education, residence, age of marriage and parity. There was a significant associa­tion between prior ectopic pregnancy (OR 15.47, CI 95% 1.92-124.3, p=0.00) , history of previous pelvic inflammatory diseases (PID) (OR 13.5, CI 95% 5.09-35.83, p=0.01), smoking (OR 15.47, CI 95% 1.92-124.3, p=0.00), history of endometriosis (OR 4.04, CI95%1.22-13.47, p=0.00), use of intrauterine contraceptive device (IUCD) (OR 5.41, CI 95% 1.66-17.65, p=0.00), and previous cesarean section(OR 2.42,CI 95%1.04-5.63, p=0.02).
 Conclusion: Identification of risk factors for ectopic pregnancy may help in early detection and appropriate management. Risk factors modification, such as cigarette smoking, use of IUCD and first pregnancy interval may be effective as risk-reduction strategies.
 Key Word: Ectopic pregnancy, Intrauterine contraceptive device, Pelvic inflammatory disease.