Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
BMC Pregnancy Childbirth ; 15: 187, 2015 Aug 22.
Article in English | MEDLINE | ID: mdl-26296545

ABSTRACT

BACKGROUND: Ectopic pregnancy (EP) is the leading cause of maternal death during the first trimester of pregnancy. A better understanding of EP risk can help prevent its occurrence. We carried out a multi-center, large-sample, case-control study to evaluate the risk factors for EP in Shanghai, China. METHODS: Women who were diagnosed with EP (n = 2411) and women with intrauterine pregnancies (n = 2416) were recruited from five hospitals in Shanghai, China. Information regarding the sociodemographic characteristics; reproductive, gynecological and surgical history; and previous and current use of contraceptives was collected from all participants. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and adjusted for potential confounding factors via multivariate logistic regression analysis. RESULTS: The study revealed that the risk of EP was associated with the traditional risk factors including previous EP (Adjusted odds ratio [AOR] = 2.72, 95% CI: 1.83-4.05), previous Chlamydia trachomatis infection (Adjusted OR = 3.18, 95% CI: 2.64, 3.84), previous infertility (AOR = 2.18, 95% CI: 1.66-2.88), previous adnexal surgery (AOR = 2.09, 95% CI: 1.49-2.93), previous appendectomy (AOR = 1.64, 95% CI: 1.13-2.37), and previous use of intrauterine devices (IUDs) (AOR = 1.72, 95% CI: 1.39-2.13). Additionally, EP risk was increased following the failure of most contraceptives used in the current cycle including IUDs (AOR = 16.43, 95% CI: 10.42-25.89), oral contraceptive pills (AOR = 3.02, 95% CI: 1.16-7.86), levonorgestrel emergency contraception (AOR = 4.75, 95% CI: 3.79-5.96), and female sterilization (AOR = 4 .73, 95% CI: 1.04-21.52). Stratified analysis showed that in vitro fertilization and embryo transfer (IVF-ET) was the main risk factor for EP in women with tubal infertility (AOR = 8.99, 95% CI: 1.98-40.84), although IVF-ET showed no association with EP in women with non-tubal infertility (AOR = 2.52, 95% CI: 0.14-44.67). CONCLUSION: In addition to the traditional risk factors, IVF-ET and current IUD use play dominant roles in the occurrence of EP. Attention should be given to women with tubal infertility who have undergone IVE-ET treatment.


Subject(s)
Chlamydia Infections/epidemiology , Infertility, Female/epidemiology , Intrauterine Devices/statistics & numerical data , Pregnancy, Ectopic/epidemiology , Adult , Appendectomy/statistics & numerical data , Case-Control Studies , China/epidemiology , Contraception, Postcoital/statistics & numerical data , Contraceptive Agents/therapeutic use , Embryo Transfer/statistics & numerical data , Female , Fertilization in Vitro/statistics & numerical data , Humans , Logistic Models , Multivariate Analysis , Odds Ratio , Pregnancy , Risk Factors , Sterilization, Reproductive/statistics & numerical data , Young Adult
2.
Sci Rep ; 5: 8487, 2015 Feb 12.
Article in English | MEDLINE | ID: mdl-25674909

ABSTRACT

Cases of ectopic pregnancy (EP) following levonorgestrel emergency contraception (LNG-EC) failure have been reported continuously, but whether there is an association between EP risk and LNG-EC is unclear. We concluded a case-control study to explore this association by recruiting 2,411 EP patients as case group, and 2,416 women with intrauterine pregnancy and 2,419 non-pregnant women as control groups. Odds ratios (ORs) and their 95% confidential intervals (CIs) were calculated and adjusted for potential confounding factors. Previous use of LNG-EC was not correlated with the EP. Compared to women who did not use contraceptives, current use of LNG-EC reduced the risk for intrauterine pregnancy (Adjusted OR [AOR] = 0.20, 95%CI: 0.14-0.27), but did not increase the risk for EP (AOR2 = 1.04, 95%CI: 0.76-1.42). Furthermore, compared to women who did not have further act of intercourse, women with unprotected further act of intercourse were at a higher risk of EP (AOR1 = 2.35, 95%CI: 1.17-4.71), and women with repeated use of LNG-EC for further intercourse during the same cycle was also associated with a higher risk for EP (AOR1 = 3.08, 95%CI: 1.09-8.71; AOR2 = 2.49, 95%CI: 1.00-6.19). A better understanding of the risk of EP following LNG-EC failure can optimize LNG-EC use and thus reduce the risk of EP.


Subject(s)
Contraception, Postcoital/adverse effects , Contraceptive Agents, Female/adverse effects , Levonorgestrel/adverse effects , Pregnancy, Ectopic/epidemiology , Pregnancy, Ectopic/etiology , Adolescent , Adult , Case-Control Studies , Female , Humans , Middle Aged , Pregnancy , Risk , Young Adult
3.
BMJ Open ; 4(12): e006447, 2014 Dec 03.
Article in English | MEDLINE | ID: mdl-25472658

ABSTRACT

OBJECTIVE: To identify risk factors for ovarian pregnancy (OP) and compare clinical features between OP and tubal pregnancy (TP) patients. DESIGN: Case-control study. SETTING: University hospital. PARTICIPANTS: A case-control study was conducted from January 2005 to May 2014. Women diagnosed with OP were recruited as the case group (n=71), 145 women with TP and 146 with intrauterine pregnancy (IUP) were matched as controls at a ratio of 1:2:2. Women who refused interviews or provided incomplete information were excluded. RESULTS: OP risk was lower than TP risk in women with serological evidence of Chlamydia trachomatis infection (adjusted OR1 0.17, 95% CI 0.06 to 0.52), previous adnexal surgery (adjusted OR1 0.25, 95% CI 0.07 to 0.95), and current levonorgestrel emergency contraceptive use (adjusted OR1 0.24, 95% CI 0.07 to 0.78). In vitro fertilisation-embryo transfer (IVF-ET) carried a higher risk of OP (adjusted OR1 12.18, 95% CI 2.23 to 66.58) than natural conception. When Controlled by IUP women, current users of intrauterine devices (IUDs) carried a higher risk of OP than non-users of any contraceptives (adjusted OR2 9.60, 95% CI 1.76 to 42.20). ß-Human chorionic gonadotropin (hCG) levels on the day of surgery were higher in OP patients than in TP patients (p<0.01). Women with OP were less likely to initially present with vaginal bleeding than those with TP (p=0.02). Moreover, shock (p=0.02), rupture (p<0.01), haemoperitoneum (p<0.01) and emergency laparotomy (p<0.01) were more common in the OP group than in the TP group. CONCLUSIONS: IVF-ET and IUD use may be risk factors for OP, and OP patients tend to have high ß-hCG levels and a poor clinical outcome (shock, rupture, haemoperitoneum and need for emergency laparotomy). Our findings may contribute to the prevention and early diagnosis of OP.


Subject(s)
Chlamydia Infections/complications , Embryo Transfer/adverse effects , Intrauterine Devices/adverse effects , Pregnancy, Ovarian/etiology , Risk Assessment/methods , Adult , China/epidemiology , Early Diagnosis , Female , Follow-Up Studies , Humans , Incidence , Pregnancy , Pregnancy, Ovarian/diagnosis , Pregnancy, Ovarian/epidemiology , Pregnancy, Tubal/epidemiology , Pregnancy, Tubal/etiology , Retrospective Studies , Risk Factors , Young Adult
4.
PLoS One ; 9(12): e115031, 2014.
Article in English | MEDLINE | ID: mdl-25493939

ABSTRACT

OBJECTIVE: To evaluate the association between the risk of ectopic pregnancy (EP) and the use of common contraceptives during the previous and current conception/menstrual cycle. METHODS: A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411). Women with intrauterine pregnancy (IUP) (n = 2,416) and non-pregnant women (n = 2,419) were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and the corresponding 95% confidential intervals (CIs). RESULTS: Previous use of intrauterine devices (IUDs) was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27]), and the risk increased with the duration of previous use (P1 for trend <10-4, P2 for trend <10-4). The current use of most contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022]) and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]). However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07]), LNG-EC (AOR2 = 4.87 [3.88-6.10]), IUDs (AOR2 = 21.08 [13.44-33.07]), and tubal sterilization (AOR2 = 7.68 [1.69-34.80]) increased the risk of EP compared with the non-use of contraceptives. CONCLUSION: Current use of most contraceptives reduce the risk of both IUP and EP. However, if the contraceptive method fails, the proportions of EP may be higher than those of non-users. In the case of contraceptive failure in the current cycle, EP cases should be differentiated according to current use of OCPs, LNG-EC, IUDs, and tubal sterilization. In addition, attention should be paid to women with previous long-term use of IUDs.


Subject(s)
Contraceptive Agents, Female/adverse effects , Contraceptive Devices, Female/adverse effects , Pregnancy, Ectopic/etiology , Adolescent , Adult , Case-Control Studies , Contraception/adverse effects , Female , Humans , Intrauterine Devices/adverse effects , Middle Aged , Natural Family Planning Methods/adverse effects , Pregnancy , Risk Factors , Young Adult
SELECTION OF CITATIONS
SEARCH DETAIL
...