BackgroundEctopic 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.MethodsWomen 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.ResultsThe 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).ConclusionIn 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.

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Infusions prepared from raw pu-erh tea (RAPT) and ripened pu-erh tea (RIPT) showed remarkable aroma differences. Predominant odorants in RAPT and RIPT infusions were identified and compared by the combined use of gas chromatography–olfactometry, aroma extract dilution analysis, odor activity values (OAVs), and multivariate analysis. A total of 35 and 19 odorants (OAV > 1) were detected in RIPT and RAPT, respectively. Odorants in RAPT and RIPT are significantly different in both odor properties and aroma compound intensities. Overall, RAPT contained a complex variety of chemical classes with diverse odors and moderate odor intensities, while RIPT is dominated by structurally and organoleptically similar compounds with high potency. Specifically, stale and musty smelling methoxybenzenes contributed the most to RIPT, while floral-, sweet-, and woody-smelling terpene alcohols, terpene ketones, and phenolic compounds were the predominant odorants in RAPT. Orthogonal partial least squares discriminant analysis revealed that linalool, α-ionone, 1,2,4-trimethoxybenzene, 1,2,3-trimethoxy-5-methylbenzene, 1,2,3,4-tetramethoxybenzene, and 1,2,3-trimethoxybenzene underwent remarkable changes during pile fermentation and could be used as potential odor-active markers for RIPT and RAPT discrimination. The comprehensive aroma characterization of pu-erh tea and determination of the effect of pile fermentation on odorant alteration herein will provide guidance for pu-erh tea flavor quality control and evaluation.