Long-term reproductive outcomes in women whose first pregnancy is ectopic: a national controlled follow-up study

Kårhus, Line Lund; Egerup, Pia; Skovlund, Charlotte Wessel; Lidegaard, Øjvind

doi:10.1093/humrep/des375

Cited by 21 publications

(26 citation statements)

References 16 publications

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“…A Danish study found that the probability of intrauterine pregnancy increased over time for women with an ectopic first pregnancy (5), a finding compatible with the trends in the last time period of our study. Advancements in both treatment of ectopic pregnancy and assisted reproductive technology have likely improved the ability of women to achieve an intrauterine pregnancy (1,2,4,5).…”

Section: Discussionmentioning

confidence: 99%

“…Although women with a history of ectopic pregnancy are at risk for repeated ectopic pregnancies (1)(2)(3), little is known on the outcomes of future intrauterine pregnancies. Most research has focused on the ability of women with a previous ectopic pregnancy to achieve an intrauterine pregnancy (4,5) or on optimizing treatment methods to preserve fertility (3,6). Improvements in diagnosis and treatment and the increased availability of assisted reproductive technologies have increased the likelihood that women with a history of ectopic pregnancy will achieve a future intrauterine pregnancy (4).…”

mentioning

confidence: 99%

“…Most research has focused on the ability of women with a previous ectopic pregnancy to achieve an intrauterine pregnancy (4,5) or on optimizing treatment methods to preserve fertility (3,6). Improvements in diagnosis and treatment and the increased availability of assisted reproductive technologies have increased the likelihood that women with a history of ectopic pregnancy will achieve a future intrauterine pregnancy (4). Yet the lack of data on birth outcomes in future pregnancies does not allow us to identify the pregnancy disorders that should be targeted for prevention (7,8).…”

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confidence: 99%

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Ectopic pregnancy and outcomes of future intrauterine pregnancy

Chouinard

Mayrand

Ayoub

et al. 2019

Fertility and Sterility

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Objective: To provide information on the birth outcomes of future intrauterine pregnancies in women whose first pregnancy was ectopic. Design: Population-based longitudinal cohort study. Setting: All hospitals in Quebec, Canada, 1989: Group surgically treated for an ectopic first pregnancy: 15,823 women; comparison group with an intrauterine first pregnancy: 1,101,748 women. Intervention(s): Not applicable. Main Outcome Measure(s): Repeat ectopic pregnancy, future delivery of a live infant, stillbirth, cesarean delivery, preterm birth, low birth weight, preeclampsia, gestational diabetes, and postpartum hemorrhage as well as other outcomes of pregnancy. Result(s): The overall prevalence of ectopic first pregnancy was 14.2 per 1,000 women, of whom 10% of women with an ectopic first pregnancy had a future ectopic. Regardless of age, women with ectopic first pregnancies had an increased risk of adverse birth outcomes at future intrauterine pregnancies, including 1.27 times the risk of preterm birth (95% confidence interval [CI], 1.18-1.37), 1.20 times the risk of low birth weight (95% CI, 1.10-1.31), 1.21 times the risk of placental abruption (95% CI, 1.04-1.41), and 1.45 times the risk of placenta previa (95% CI, 1.10-1.91). Older women with a prior ectopic pregnancy had particularly elevated risks of placental abruption (risk ratio 1.42; 95% CI, 1.16-1.69). Conclusion(s):Women with ectopic first pregnancies have an increased risk of adverse birth outcomes during subsequent intrauterine pregnancies. These women may benefit from closer clinical management in pregnancy to prevent adverse birth outcomes. (Fertil Steril Ò 2019;112:112-9. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Ectopic pregnancy and outcomes of future intrauterine pregnancy

Chouinard

Mayrand

Ayoub

et al. 2019

Fertility and Sterility

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“…Existing studies have mainly analyzed short‐term fertility according to different treatment methods . We recently described a compromised long‐term fertility prognosis in women whose first pregnancy was ectopic , but we found no study assessing the development over time as regards the long‐term reproductive prognosis in women after an ectopic pregnancy. Reproduction is influenced by women's intention to become pregnant, and by the availability of effective fertility treatment.…”

Section: Introductionmentioning

confidence: 92%

“…We recently described a compromised long-term fertility prognosis in women whose first pregnancy was ectopic (9), but we found no study assessing the development over time…”

Section: Introductionmentioning

confidence: 96%

Improving reproductive long‐term prognosis for women with a first ectopic pregnancy. A national controlled follow‐up study

Egerup

Kårhus

Skovlund

et al. 2014

Acta Obstet Gynecol Scand

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Ectopic first pregnancy treated by methotrexate versus salpingectomy—Maternal and perinatal outcomes in a subsequent pregnancy: A retrospective study

Ohayon

Weissbach

Burke

et al. 2022

Intl J Gynecology & Obste

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Objective To study obstetric outcomes of a second pregnancy among women with a first ectopic pregnancy (EP) treated with methotrexate compared with laparoscopic salpingectomy. Methods A retrospective cohort study including all women with a first EP and a following pregnancy that concluded by delivery at ≥24 weeks of gestation between March 2011 and April 2021. Second pregnancy outcomes were compared between women treated with methotrexate and those treated with salpingectomy in their first pregnancy. Results Overall, 125 women were included, of which 64 (51.2%) were treated with methotrexate and 61 (48.8%) were treated with salpingectomy. In women treated with salpingectomy, the proportion of women conceiving by in vitro fertilization and those with measured gestational sac diameter or β‐subunit human chorionic gonadotropin was higher. The proportion of women conceiving by in vitro fertilization in their second pregnancy was higher in the salpingectomy group (55.2% versus 18.0%, P < 0.001). All maternal and neonatal outcomes were similar in both groups. The rate of low birth weight < 2500 g was 7.8% in the methotrexate group versus 18% in the salpingectomy group (P = 0.111). Conclusion Maternal and neonatal outcomes of a second pregnancy among women treated for EP in their first pregnancy are similar in women treated by methotrexate and those treated by salpingectomy.

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Long-term reproductive outcomes in women whose first pregnancy is ectopic: a national controlled follow-up study

Abstract: All the expenses were covered by Gynaecological Clinic, Rigshospitalet. Ø.L. has within the last 3 years received honoraria for speeches in pharmacoepidemiological issues. L.L.K., P.E. and C.W.S. had no conflict of interest to declare.

Cited by 21 publications

References 16 publications

Ectopic pregnancy and outcomes of future intrauterine pregnancy

Ectopic pregnancy and outcomes of future intrauterine pregnancy

Improving reproductive long‐term prognosis for women with a first ectopic pregnancy. A national controlled follow‐up study

Ectopic first pregnancy treated by methotrexate versus salpingectomy—Maternal and perinatal outcomes in a subsequent pregnancy: A retrospective study

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