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1: Am J Obstet Gynecol. 1990 Oct;163(4 Pt 1):1120-3.Links
Comment in:
Am J Obstet Gynecol. 1991 Dec;165(6 Pt 1):1900.

Contraception and ectopic pregnancy risk.

Franks AL, Beral V, Cates W Jr, Hogue CJ.

Division of Reproductive Health, Centers for Disease Control, Atlanta, GA 30333.

Studies of the association of ectopic pregnancy with contraception have generated a conflicting array of results because of methodologic differences between studies. We estimated the absolute incidence rates of ectopic pregnancy for various contraceptives by multiplying the pregnancy rate by the proportion of pregnancies with ectopic implantation for each method. Our results indicated a more than 500-fold difference in ectopic pregnancy incidence, from a low of 0.005 ectopic pregnancies per 1000 women years of oral contraception or vasectomy to a high of 2.6 per 1000 women years of no contraception. These estimated incidence rates should be useful for clinicians and patients seeking to better understand the risks and benefits of contraceptives.

PIP: Studies of the association of ectopic pregnancy with contraception have generated a conflicting array of results because of methodological differences between studies. We believed that absolute rates of occurrence are useful in clinical decision-making for expressing risks of disease. We estimated the absolute incidence rates of ectopic pregnancy for various contraceptives by multiplying the pregnancy rate by the proportion of pregnancies with ectopic implantation for each method. It is assumed that no differences exist in the proportion of ectopic pregnancies among women using combination oral contraceptives, women using barrier methods, women whose partners had vasectomies, and women using no contraception. It was also assumed that the ectopic pregnancy rate is the product of the pregnancy rate and the likelihood of ectopic implantation. Our results indicated a more than 500-fold difference in ectopic pregnancy incidence, from a low of 0.005 ectopic pregnancies/1000 women years of oral contraception or vasectomy to a high of 2.6/1000 women years include 0.100 for condoms, 0.150 for diaphragms, 0.318 for tubal sterilization, and 1.020 for IUDs. These estimated incidence rates should be useful for clinicians and patients seeking to better understand the risks and benefits of contraceptives. (author's modified).

PMID: 2220914 [PubMed - indexed for MEDLINE]