Menon Seema, Sammel Mary D, Vichnin Michelle, Barnhart Kurt T
Penn Fertility Care, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
J Pediatr Adolesc Gynecol. 2007 Jun;20(3):181-5. doi: 10.1016/j.jpag.2007.01.007.
To compare the prevalence of classical risk factors and presenting signs and symptoms between adolescents and adults with ectopic pregnancy (EP).
A database containing information regarding presentation symptoms, past medical history, and ultimate pregnancy outcomes of patients presenting to the Emergency Department during early pregnancy is maintained in our institution. Data were extracted and analyzed for all patients ultimately diagnosed with EP. Patients were separated into adult (> or =20 years of age) and adolescent groups (<20 years of age). Adjusted comparisons were made between these two groups regarding pain, vaginal bleeding, current and past pelvic infections, prior pregnancy history, and prior surgery using Pearson's chi-square, t test, and multivariable models.
The incidence of EP was lower in the adolescent group versus the adult group (9.7% versus 21.7%). Classical risk factors such as prior EP (P < 0.01), and prior pelvic surgery (P < 0.01) were significantly more likely to be associated with adults than adolescents with EP. Adolescent patients were significantly more likely to present with abdominal pain (P = 0.045) and current gonorrhea and/or chlamydia (gc/ct) infection (P < 0.01).
This preliminary study suggests that different risk factors may be associated with EP in adolescents compared to adults.
比较异位妊娠（EP）青少年患者与成年患者中经典危险因素以及就诊时体征和症状的发生率。
我们机构维护了一个数据库，其中包含早孕期间到急诊科就诊患者的症状表现、既往病史及最终妊娠结局等信息。提取并分析所有最终诊断为EP的患者的数据。将患者分为成年组（≥20岁）和青少年组（<20岁）。使用Pearson卡方检验、t检验和多变量模型对这两组在疼痛、阴道出血、当前和既往盆腔感染、既往妊娠史及既往手术方面进行校正比较。
青少年组EP的发生率低于成年组（9.7%对21.7%）。与EP青少年患者相比，成年患者更易出现如既往EP（P<0.01）和既往盆腔手术（P<0.01）等经典危险因素。青少年患者更易出现腹痛（P=0.045）以及当前淋病和/或衣原体（gc/ct）感染（P<0.01）。
这项初步研究表明，与成年人相比，青少年EP可能存在不同的危险因素。
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