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Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France.
Bouyer J., Coste J., Shojaei T., Pouly J.-L., Fernandez H., Gerbaud L., Job-Spira N.
American Journal of Epidemiology 157, 3 (2003) 185-94 - http://www.hal.inserm.fr/inserm-00086499
(12543617)
Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France.
Jean Bouyer () 1, Joël Coste1, Taraneh Shojaei1, Jean-Luc Pouly2, Hervé Fernandez1, 3, Laurent Gerbaud4, Nadine Job-Spira1
1:  Epidémiologie, Démographie et Sciences Sociales: santé reproductive, sexualité et infection à VIH
INSERM : U569 – INED – IFR69 – Université Paris XI - Paris Sud
Secteur Bleu 82, Rue du General Leclerc 94276 LE KREMLIN BICETRE CEDEX
France
2:  Service de Gynécologie-Obstétrique
Centre Hospitalier Hôtel-Dieu
Clermont-Ferrand
France
3:  Service de gynécologie-obstétrique, médecine de la reproduction [Béclère]
Assistance publique - Hôpitaux de Paris (AP-HP) – Hôpital Antoine Béclère – Université Paris XI - Paris Sud
157, rue de la Porte de Trivaux 92141 Clamart
France
4:  Service d'Epidémiologie et de Santé Publique
Centre Hospitalier Hôtel-Dieu
Clermont-Ferrand
France
This case-control study was associated with a regional register of ectopic pregnancy between 1993 and 2000 in France. It included 803 cases of ectopic pregnancy and 1,683 deliveries and was powerful enough to investigate all ectopic pregnancy risk factors. The main risk factors were infectious history (adjusted attributable risk = 0.33; adjusted odds ratio for previous pelvic infectious disease = 3.4, 95% percent confidence interval (CI): 2.4, 5.0) and smoking (adjusted attributable risk = 0.35; adjusted odds ratio = 3.9, 95% CI: 2.6, 5.9 for >20 cigarettes/day vs. women who had never smoked). The other risk factors were age (associated per se with a risk of ectopic pregnancy), prior spontaneous abortions, history of infertility, and previous use of an intrauterine device. Prior medical induced abortion was associated with a risk of ectopic pregnancy (adjusted odds ratio = 2.8, 95% CI: 1.1, 7.2); no such association was observed for surgical abortion (adjusted odds ratio = 1.1, 95% CI: 0.8, 1.6). The total attributable risk of all the factors investigated was 0.76. As close associations were found between ectopic pregnancy and infertility and between ectopic pregnancy and spontaneous abortion, further research into ectopic pregnancy should focus on risk factors common to these conditions. In terms of public health, increasing awareness of the effects of smoking may be useful for ectopic pregnancy prevention.
Life Sciences/Health Care Sciences and Epidemiology
English
0002-9262

Article in peer-reviewed journal
American Journal of Epidemiology (Am J Epidemiol)
Publisher Oxford University Press (OUP): Policy B
ISSN 0002-9262 (eISSN : 1476-6256)
2003-02-01
157
3
185-94

Adult – Case-Control Studies – Communicable Diseases – Confidence Intervals – Female – France – Humans – Incidence – Parity – Pregnancy – Ectopic – Registries – Research Support – Non-U.S. Gov't – Risk Factors – Smoking – Adult – Communica
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