Ectopic Pregnancy in China during 2011-2020: A Single-Centre Retrospective Study of 9499 Cases

Abstract

Background: Previous studies have shown that the incidence of ectopic pregnancy (EP) is increasing in China. It is unclear, however, whether the incidence of EP has changed after the implementation of the universal two-child policy in the context of China's aging population and declining fertility rate. Methods: Data with respect to EP were collected from the hospital's electronic medical records from January 2011 to December 2020, which included the annual number of delivery, cesarean section rate and ectopic pregnancies, treatment of tubal pregnancy, and averaged costs and length of stay in the hospital. Trends were analyzed and annual percentage change (APC) was calculated using connected point regression analyzes. Results: A total of 9499 cases of EP were collected, among which cesarean scar pregnancy (CSP) account for the second most (6.73%). The EP per 100 deliveries revealed a downward trend, from 7.60% in 2011 to 4.28% in 2020 with an APC of -1.87 (P < 0.05). The maternal age was increased, especially after the implementation of the universal two-child policy. Constituent ratio for the advanced maternal age (≥ 35) and the cesarean section rate, but not the CSP, were also increased. Laparoscopic salpingectomy was the main surgical method, whereas the adoption of laparotomy and laparoscopic salpingostomy was decreasing year by year. Conclusions: Although the implementation of the universal two-child policy increased the number of births, the proportion of older mothers and cesarean section rate, this policy change seems to be less effective on EP.