Tao Guoyu, Patel Chirag, Hoover Karen W
From the Division of STD Prevention and the Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
South Med J. 2017 Jan;110(1):18-24. doi: 10.14423/SMJ.0000000000000594.
To update trends in the rates of ectopic pregnancy, to compare rates of ectopic pregnancy between commercially insured and Medicaid-insured women, and to assess the differences in rates of ectopic pregnancy by different measures of ectopic pregnancy.
We analyzed data from 2002 to 2013 using the Truven Health MarketScan Commercial and Medicaid Claims Database. We limited the study population to women aged 15 to 44 years with any pregnancy in each year. Pregnancy and ectopic pregnancy were identified by clinical services with diagnostic or procedural codes. Ectopic pregnancy was measured in two ways: diagnosed and treated compared with diagnosed only; pregnancy was measured in two ways: any pregnancy compared with pregnancy with delivery.
We did not observe a substantial trend in the rate of ectopic pregnancy from 2002 to 2013. The rate of diagnosed and treated ectopic pregnancy substantially increased by age: 0.29% in women aged 15 to 19 years and 0.89% in women aged 40 to 44 years among the commercially insured population and 0.23% and 0.85% among the Medicaid-insured population, respectively. The rate of ectopic pregnancy also varied by the different methodologies used to estimate rates.
The rate of ectopic pregnancy is relatively low and stable for women of reproductive age in the United States. Our findings highlight that it is important to clearly define the numerator and denominator in the measure of ectopic pregnancy rates.
更新异位妊娠发生率的趋势，比较商业保险女性和医疗补助保险女性的异位妊娠发生率，并通过不同的异位妊娠测量方法评估异位妊娠发生率的差异。
我们使用Truven Health MarketScan商业和医疗补助索赔数据库分析了2002年至2013年的数据。我们将研究人群限制为每年有任何妊娠的15至44岁女性。通过带有诊断或程序代码的临床服务来识别妊娠和异位妊娠。异位妊娠通过两种方式进行测量：诊断并治疗的与仅诊断的进行比较；妊娠通过两种方式进行测量：任何妊娠与分娩的妊娠进行比较。
我们未观察到2002年至2013年异位妊娠发生率有显著趋势。在商业保险人群中，诊断并治疗的异位妊娠发生率随年龄大幅增加：15至19岁女性为0.29%，40至44岁女性为0.89%；在医疗补助保险人群中分别为0.23%和0.85%。异位妊娠发生率也因用于估计发生率的不同方法而有所差异。
在美国，育龄女性的异位妊娠发生率相对较低且稳定。我们的研究结果强调，在测量异位妊娠率时明确分子和分母很重要。
