Moini Ashraf, Hosseini Reihaneh, Jahangiri Nadia, Shiva Marzieh, Akhoond Mohammad Reza
Department of Endocrinology and Female Infertility at Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran ; Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran ; Department of Gynecology and Obstetrics, Arash Women's Health Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Gynecology and Obstetrics, Arash Women's Health Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Res Med Sci. 2014 Sep;19(9):844-9.
Ectopic pregnancy (EP) is a condition presenting as a major health problem for women of childbearing age. This study aimed to identify potential risk factors for EP and to evaluate the contribution of the risk factors associated to EP.
This retrospective nested case-control study was conducted from 2006 to 2011. In case group, there were a total of 83 women diagnosed with EP, while in the control group; there was a total of 340 women who gave birth. The basic recorded information included surgical, gynecological, obstetrics, sexual, contraceptive, and infectious histories; demographic characteristics; smoking habits; fertility markers; as well as reproductive outcome after EP. The association between EP and the factors studied was analyzed by logistic regression.
The findings reveal that the following factors were associated with increased risk of EP, including: Maternal age (odds ratio [OR] =1.11, confidence interval [CI] [1.06-1.16], P < 0.0001), spouse's cigarette smoking (OR = 1.73, CI [1.05-2.85], P = 0.02), gravidity (OR = 1.50, CI [1.25-1.80], P < 0.0001), prior spontaneous abortions (OR = 1.93, CI [1.11-3.36], P = 0.01), history of EP (OR = 17.16, CI [1.89-155.67], P = 0.01), tubal blockage (OR = 10.85, CI [2.02-58.08], P = 0.01), use of intrauterine device (IUD) (OR = 4.39, CI [1.78-10.81], P = 0.001), tubal damage (OR = 2.704, CI [1.26-5.78], P = 0.01), first pregnancy interval (OR = 1.01, CI [1.00-1.02], P < 0.0001) and history of infertility (OR = 6.13, CI [2.70-13.93], P < 0.0001).
By identifying risk factors being amenable to modification, such as cigarette smoking and use of IUD and first pregnancy interval the effective risk-reduction strategies can be devised.
异位妊娠（EP）是育龄期女性面临的一个主要健康问题。本研究旨在确定EP的潜在危险因素，并评估与EP相关的危险因素的作用。
本回顾性巢式病例对照研究于2006年至2011年进行。病例组共有83例被诊断为EP的女性，对照组共有340例分娩女性。记录的基本信息包括手术史、妇科病史、产科病史、性生活史、避孕史和感染史；人口统计学特征；吸烟习惯；生育指标；以及EP后的生殖结局。通过逻辑回归分析EP与所研究因素之间的关联。
研究结果显示，以下因素与EP风险增加相关，包括：产妇年龄（优势比[OR]=1.11，置信区间[CI][1.06-1.16]，P<0.0001）、配偶吸烟（OR=1.73，CI[1.05-2.85]，P=0.02）、妊娠次数（OR=1.50，CI[1.25-1.80]，P<0.0001）、既往自然流产史（OR=1.93，CI[1.11-3.36]，P=0.01）、EP病史（OR=17.16，CI[1.89-155.67]，P=0.01）、输卵管堵塞（OR=10.85，CI[2.02-58.08]，P=0.01）、宫内节育器（IUD）使用（OR=4.39，CI[1.78-10.81]，P=0.001）、输卵管损伤（OR=2.704，CI[1.26-5.78]，P=0.01）、首次妊娠间隔（OR=1.01，CI[1.00-1.02]，P<0.0001）和不孕史（OR=6.13，CI[2.70-13.93]，P<0.0001）。
通过识别可改变的危险因素，如吸烟、IUD使用和首次妊娠间隔，可以制定有效的降低风险策略。
