Faculty of Health Sciences, Joyce and Irving Goldman Medical School at Ben Gurion University of the Negev, Beer-Sheva, Israel.
Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, POB 151, 84101, Beer-Sheva, Israel.
Arch Gynecol Obstet. 2021 Sep;304(3):633-640. doi: 10.1007/s00404-021-05991-2. Epub 2021 Feb 10.
To evaluate perinatal outcomes and long-term neurological morbidity of offspring to mothers with a history of ectopic pregnancy.
In this retrospective study, perinatal outcomes and long-term neurological morbidity of offspring were assessed among mothers with a history of ectopic pregnancy, either medically or surgically treated. The study groups were followed until 18 years of age for neurological-related morbidity. For perinatal outcomes, generalized estimated equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative neurological morbidity incidence and Cox proportional hazards model was conducted to control for confounders.
A total of 243,682 mothers were included; 1424 mothers (0.58%) had a previous ectopic pregnancy, of which 25.6% (n = 365) were treated medically, and 74.3% (n = 1059) were treated surgically. Using GEE models, controlling for confounders, both surgically and medically treated ectopic pregnancies were noted as independent risk factors for preterm delivery in the subsequent pregnancies. Maternal history of surgically treated ectopic pregnancy was also independently associated with cesarean delivery. Offspring to mothers with previous ectopic pregnancy had comparable rates of long-term neurological morbidity. In the Cox proportional hazards model, controlling for confounders, being born to a mother with a history of previous ectopic pregnancy was not found to be independently associated with long-term neurological morbidity of offspring.
Maternal history of ectopic pregnancy is independently associated with preterm delivery. However, offspring of mothers with a history of ectopic pregnancy are not at an increased risk for long-term neurological morbidity.
评估有异位妊娠史的母亲所生孩子的围产期结局和长期神经发育不良。
在这项回顾性研究中，评估了经医学或手术治疗的异位妊娠史母亲所生孩子的围产期结局和长期神经发育不良。研究组随访至 18 岁，以评估与神经相关的发病率。对于围产期结局，使用广义估计方程（GEE）模型来控制混杂因素。使用 Kaplan-Meier 生存曲线比较累积神经发育不良发生率，并用 Cox 比例风险模型来控制混杂因素。
共纳入 243682 名母亲；1424 名母亲（0.58%）有过异位妊娠史，其中 25.6%（n=365）经医学治疗，74.3%（n=1059）经手术治疗。使用 GEE 模型，控制混杂因素后，手术和药物治疗的异位妊娠均被认为是随后妊娠早产的独立危险因素。既往手术治疗的异位妊娠史也与剖宫产分娩独立相关。有异位妊娠史母亲所生孩子的长期神经发育不良发生率相当。在 Cox 比例风险模型中，控制混杂因素后，母亲有异位妊娠史与孩子的长期神经发育不良无关。
母亲有异位妊娠史与早产独立相关。然而，有异位妊娠史母亲所生孩子发生长期神经发育不良的风险没有增加。
