Marchbanks P A, Annegers J F, Coulam C B, Strathy J H, Kurland L T
Reproductive Health, Centers for Disease Control, Atlanta.
JAMA. 1988 Mar 25;259(12):1823-7.
To evaluate the association between ectopic pregnancy and 22 potential risk factors, we conducted a population-based case-control study. The investigation included 274 cases diagnosed from 1935 through 1982 in residents of Rochester, Minn, and 548 matched controls selected from live-birth deliveries. Risk factor information documented prior to the last index menstrual period was obtained via medical record abstract. Univariate matched analyses revealed nine variables associated with a significantly elevated relative risk of ectopic pregnancy. Following conditional logistic regression, four variables remained as strong and independent risk factors for ectopic pregnancy: current intrauterine device use (relative risk, 13.7; 95% confidence interval, 1.6 to 120.6), a history of infertility (relative risk, 2.6; 95% confidence interval, 1.6 to 4.2), a history of pelvic inflammatory disease (relative risk, 3.3; 95% confidence interval, 1.6 to 6.6), and prior tubal surgery (relative risk, 4.5; 95% confidence interval, 1.5 to 13.9). Theoretically, any condition that prevents or retards migration of the fertilized ovum to the uterus could predispose a woman to ectopic gestation. Further research is needed to clarify the impact of other potential risk factors in the etiology of ectopic pregnancy.
为评估异位妊娠与22种潜在危险因素之间的关联，我们开展了一项基于人群的病例对照研究。该调查纳入了1935年至1982年在明尼苏达州罗切斯特市居民中诊断出的274例病例，以及从活产分娩中选取的548例匹配对照。通过病历摘要获取末次月经前记录的危险因素信息。单因素匹配分析显示有9个变量与异位妊娠相对风险显著升高相关。经过条件逻辑回归分析，有4个变量仍然是异位妊娠的强烈且独立的危险因素：当前使用宫内节育器（相对风险为13.7；95%置信区间为1.6至120.6）、不孕史（相对风险为2.6；95%置信区间为1.6至4.2）、盆腔炎病史（相对风险为3.3；95%置信区间为1.6至6.6）以及既往输卵管手术史（相对风险为4.5；95%置信区间为1.5至13.9）。从理论上讲，任何阻止或延缓受精卵向子宫迁移的情况都可能使女性易患异位妊娠。需要进一步研究以阐明其他潜在危险因素在异位妊娠病因学中的影响。
