Temporal trends in severe morbidity and mortality associated with ectopic pregnancy requiring hospitalisation in Washington State, USA: a population-based study

被引：20

作者：

Lisonkova, Sarka ^{[1
,2
,3
,4
]}

Tan, Justin ^{[1
,2
,3
]}

Wen, Qi ^{[1
,2
,3
]}

Abdellatif, Lobna ^{[1
,2
,3
]}

Richter, Lindsay L. ^{[1
,2
,3
]}

Alfaraj, Sukainah ^{[1
,2
,3
]}

Yong, Paul J. ^{[1
,2
,3
]}

Bedaiwy, Mohamed A. ^{[1
,2
,3
]}

机构：

[1] Univ British Columbia, Dept Obstet & Gynaecol, Vancouver, BC, Canada

[2] Childrens & Womens Hosp, Vancouver, BC, Canada

[3] Hlth Ctr British Columbia, Vancouver, BC, Canada

[4] Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada

来源：

BMJ OPEN | 2019年 / 9卷 / 02期

关键词：

UNITED-STATES; MANAGEMENT; COMPLICATIONS; METHOTREXATE; PREDICTORS; DIAGNOSIS; OUTCOMES; WOMEN; RISK; CARE;

D O I：

10.1136/bmjopen-2018-024353

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To examine temporal trend in maternal mortality/severe morbidity associated with hospitalisation due to ectopic pregnancy. Design A population-based observational study. Setting and participants All women hospitalised for ectopic pregnancy in Washington State, USA, 1987-2014 (n=20 418). The main composite outcome of severe morbidity/mortality included death, sepsis, need for transfusion, hysterectomy and systemic or organ failure, identified by diagnostic and procedure codes from hospitalisation files. Severe morbidity/mortality due to ectopic pregnancy were expressed as incidence ratios among women of reproductive age (15-64 years) and among women hospitalised for ectopic pregnancy. Comparisons were made between 1987-1991 (reference) and 2010-2014 using ratios of incidence ratios (RR) and ratio differences (RD). The Cochran-Armitage test for trend assessed statistical significance; logistic regression was used to obtain adjusted OR (AOR) and 95% CI, adjusted for demographic factors and comorbidity. Results Hospitalisation for ectopic pregnancy declined from 0.89 to 0.16 per 1000 reproductive age women between 1987-1991 and 2010-2014 (p<0.001). Among reproductive age women, ectopic pregnancy mortality remained stable (0.03 per 100 000); and mortality/severe morbidity increased among women aged 25-34 years (p=0.022). Among women hospitalised for ectopic pregnancy, mortality increased from 0.29 to 1.65 per 1000 between 1987-1991 and 2010-2015 (p=0.06); severe morbidity/mortality increased from 3.85% to 19.63% (RR=5.10, 95% CI 4.36 to 5.98; RD=15.78 per 100 women, 95% CI 13.90 to 17.66; AOR for 1-year change was 1.08, 95% CI 1.07 to 1.08). Conclusions Hospitalisation for ectopic pregnancy declined in Washington State, USA, between 1987 and 2014; however, mortality/severe morbidity associated with ectopic pregnancy increased in female population aged 25-34 years.

引用

页数：8

共 34 条

[1] The medical management of ectopic pregnancy: A meta-analysis comparing "single dose" and "multidose" regimens [J].