Sapapsap Bannawich, Leelakanok Nattawut, Boonpattharatthiti Kansak, Siritientong Tippawan, Methaneethorn Janthima
Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, Chonburi, Thailand.
Department of Food and Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand.
Expert Opin Drug Saf. 2023 Jul-Dec;22(10):929-941. doi: 10.1080/14740338.2023.2247965. Epub 2023 Aug 17.
The use of levonorgestrel emergency oral contraceptives (EOCs) is one of the factors that may be associated with ectopic pregnancy. We aimed to investigate the incidence of ectopic pregnancy in EOC users and the association between EOCs and ectopic pregnancy.
We searched for articles that provided the incidence of and the association between levonorgestrel EOCs and ectopic pregnancy in women of reproductive ages in CINAHL Complete, Medline, OpenDissertations, Scopus, Science Direct, and Thai Journal Online. The risk of bias was assessed by Risk Of Bias In Non-randomized Studies or Risk of Bias 2. A meta-analysis was conducted using the random-effects model.
We retrieved 1839 nonredundant articles from the systematic search. The meta-analysis showed that the prevalence of ectopic pregnancy was not statistically different from zero (pooled prevalence estimate = 0.029%; 95%CI: -0.006, 0.065; = 9; I = 0) and rare. In addition, levonorgestrel EOCs increased the risk of ectopic pregnancy (OR = 6.17; 95%CI: 3.78, 10.08; = 5; I = 43%).
Women with extrauterine or ectopic pregnancy had higher odds of using levonorgestrel emergency oral contraceptives than those with intrauterine pregnancy. However, the prevalence of ectopic pregnancy is rare.
左炔诺孕酮紧急口服避孕药（EOC）的使用是可能与异位妊娠相关的因素之一。我们旨在调查EOC使用者中异位妊娠的发生率以及EOC与异位妊娠之间的关联。
我们在CINAHL Complete、Medline、OpenDissertations、Scopus、Science Direct和泰国在线期刊中搜索了提供育龄女性中左炔诺孕酮EOC与异位妊娠的发生率及关联的文章。采用非随机研究中的偏倚风险或偏倚风险2评估偏倚风险。使用随机效应模型进行荟萃分析。
通过系统检索，我们获取了1839篇非重复文章。荟萃分析表明，异位妊娠的患病率与零无统计学差异（合并患病率估计值 = 0.029%；95%置信区间：-0.006，0.065；k = 9；I² = 0），且较为罕见。此外，左炔诺孕酮EOC增加了异位妊娠的风险（比值比 = 6.17；95%置信区间：3.78，10.08；k = 5；I² = 43%）。
与宫内妊娠的女性相比，宫外或异位妊娠的女性使用左炔诺孕酮紧急口服避孕药的几率更高。然而，异位妊娠的患病率较低。
