Risk factors for cervical ectopic pregnancy

Luis R Hoyos; Sejal Tamakuwala; Anupama Rambhatla; Harpreet Brar; Gustavo Vilchez; Jenifer Allsworth; Javier Rodriguez-Kovacs; Awoniyi Awonuga

doi:10.1016/j.jogoh.2019.101665

Risk factors for cervical ectopic pregnancy

J Gynecol Obstet Hum Reprod. 2019 Dec 5:101665. doi: 10.1016/j.jogoh.2019.101665. Online ahead of print.

Authors

Luis R Hoyos¹, Sejal Tamakuwala², Anupama Rambhatla³, Harpreet Brar³, Gustavo Vilchez⁴, Jenifer Allsworth⁵, Javier Rodriguez-Kovacs⁶, Awoniyi Awonuga³

Affiliations

¹ Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States. Electronic address: lhoyosmartinez@mednet.ucla.edu.
² Department of Obstetrics & Gynecology, Emory University, Atlanta, GA, United States; Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States.
³ Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States.
⁴ Department of Obstetrics & Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.
⁵ University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States.
⁶ Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States; Department of Obstetrics & Gynecology, University of Chicago, Chicago, IL, United States.

PMID: 31811970
DOI: 10.1016/j.jogoh.2019.101665

Abstract

Objective: To evaluate risk factors for cervical ectopic pregnancies.

Methods: Retrospective, quasi-experimental case-control study of cervical ectopic pregnancy (CEP) cases from 2000-2013. Two groups were selected as controls, patients with tubal ectopic (TEP) and intrauterine pregnancies (IUP) without a history of TEP, matched by year of pregnancy and randomly sampled in a 1:3 case-control ratio per each study group.

Results: 21 cases were identified and 126 controls included, 63 TEP and IUP each. A binary logistic regression model was used to analyze whether statistically significant preceding factors from a bivariate analysis could predict CEP. Compared to patients with IUP, CEP patients had a higher history of elective abortions, D&C and cervical excisional procedures, with a high effect size (>0.7). Compared to patients with TEP, CEP patients had a higher history of D&C and cervical excisional procedures, with a high effect size (>.7). The risk of CEP was significantly higher with a prior history of D&C compared to an IUP (aOR 1.4; 95% CI, 1.1-9.1; p=0.04) and a TEP (aOR 6.1; 95% CI, 1.8-21.2; p=0.04).

Conclusion: D&C is a strong risk factor for CEP when compared to pregnancies in other locations. These findings confirm previous associations described in case series.

Keywords: Cervical ectopic pregnancy; Risk factors.