Population-based ectopic pregnancy trends, 1993-2007.
Population-based ectopic pregnancy trends, 1993-2007.
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基于人群的宫外孕趋势，1993-2007 年。
DOI：
10.1016/j.amepre.2010.12.026
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发表时间：
2011
影响因子：
5.5
通讯作者：
Scholes,Delia
中科院分区：
文献类型：
--
作者：
Trabert,Britton;Holt,VictoriaL;Yu,Onchee;VanDenEeden,StephenK;Scholes,Delia
基于全国代表性数据的异位妊娠率的准确性多年来一直受到损害，损害了对这种状况的持续公共卫生重要性的监测和评估。为了估计在很大程度上未评估的时间段内定义人群内的长期基于人群的异位妊娠率和趋势，包括对门诊病人与住院病人管理和内科与外科治疗方式的趋势的评价。计算了1993年至2007年15-44岁登记者的年龄调整和年龄特异性异位妊娠率。还评价了总体趋势和护理环境（住院与门诊）和治疗方式（内科与外科）的趋势。在1993年至2007年期间，在1，180，070名妇女年中，共确定了2114例异位妊娠病例（726例住院患者; 1388例门诊患者），年年龄调整异位妊娠率为17.9/10，000名妇女年。1993年至2004年，这一比率保持稳定，最近3年有所上升（2005-2007年，比率为每10 000名妇女-年21.1人）。在15年期间，每1000例妊娠的发生率从19.2例增加到26.2例（p值=0.001）。住院诊断病例从1993-1995年的45.4%下降到2005-2007年的26.9%（p值<0.0001），手术治疗的百分比从48.1%下降到30.7%（p值<0.0001）。发病率与上次可用的全国估计相似，这表明宫外孕作为公共卫生问题的重要性在这些年中并未减弱。
BACKGROUNDThe accuracy of ectopic pregnancy rates based on nationally representative data has been compromised for many years, impairing surveillance and evaluation of the continued public health importance of this condition.PURPOSETo estimate long-term population-based ectopic pregnancy rates and trends within a defined population over a largely unevaluated time period, including the evaluation of trends in outpatient versus inpatient management and medical versus surgical treatment modalities.METHODSUsing computerized Group Health Cooperative inpatient and outpatient data, age-adjusted and age-specific ectopic pregnancy rates were calculated from 1993 to 2007 among enrollees aged 15–44 years. Overall trends and trends for care setting (inpatient versus outpatient) and treatment modality (medical versus surgical) were also evaluated. Analyses were conducted in 2009.RESULTSBetween 1993 and 2007, a total of 2114 ectopic pregnancy cases (726 inpatient; 1388 outpatient) were identified among 1,180,070 woman-years, an annual age-adjusted ectopic pregnancy rate of 17.9 per 10,000 woman-years. Rates were stable from 1993 to 2004 and increased in the most recent 3 years (2005–2007, rate=21.1 per 10,000 woman-years). Rates per 1000 pregnancies increased over the 15-year period from 19.2 to 26.2 per 1000 pregnancies (p-value=0.001). Inpatient-diagnosed cases decreased from 45.4% in 1993–1995 to 26.9% in 2005–2007 (p-value<0.0001) and the percentage with surgical treatment decreased from 48.1% to 30.7% (p-value<0.0001).CONCLUSIONSThe results suggest a trend toward increasing ectopic pregnancy rates over a recent 15-year period. Rates are similar to the last available national estimate, suggesting that the significance of ectopic pregnancy as a public health problem has not diminished in these intervening years.