Ectopic pregnancy in China during 2011-2020: a single-centre retrospective study of 9499 cases

• Published in: BMC pregnancy and childbirth Vol. 22; no. 1; p. 928
• Main Authors: Xu, Haihua, Lin, Guan, Xue, Lifang, Wu, Weifang, Ding, Jinlian, Liu, Chaobin
• Format: Journal Article
• Language: English
• Published: England BioMed Central 10-12-2022; BMC
• Subjects: Advanced-age pregnant women; Age; Aged; Birth control; Caesarean scar pregnancy; Cesarean Section; Developing countries; Ectopic pregnancy; Family planning; Female; Fertility; Fertility policy change; Gonorrhea; Gynecology; Hospitals; Humans; Immune system; Laparoscopy; Laparotomy; LDCs; Length of stay; Maternal & child health; Obstetrics; Ovaries; Pregnancy; Pregnancy complications; Pregnancy, Ectopic - epidemiology; Pregnancy, Ectopic - etiology; Pregnancy, Ectopic - therapy; Recurrence; Retrospective Studies; Sexually transmitted diseases; STD; Syphilis; Trends; Womens health; United Kingdom > UK; United States > US; China; Caesarean scar pregnancy; Ectopic pregnancy; Fertility policy change; Advanced-age pregnant women
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-022-05269-8

Previous studies have shown that the incidence of ectopic pregnancy (EP) is increasing in China. It is unclear, however, whether the incidence of EP has changed after the implementation of the universal two-child policy in the context of China's aging population and declining fertility rate.
Data concerning EP from January 2011 to December 2020 were collected from the hospital's electronic medical records, which included the annual number of delivery, caesarean section rate, ectopic pregnancies, treatment of tubal pregnancy, and average costs and length of hospitalization. Trends of the EP incidence were analysed and annual percentage change (APC) was calculated using connected point regression analyses.
A total of 9499 cases of EP were collected, among which caesarean scar pregnancy (CSP) accounts for the second highest (6.73%). The EP per 100 deliveries revealed a downward trend, from 7.60% in 2011 to 4.28% in 2020 with an APC of -1.87 (P < 0.05). The maternal age was increased, especially after the implementation of the universal two-child policy. The constituent ratio for the advanced maternal age (≥ 35) and the caesarean section rate, but not the CSP, were also increased. Laparoscopic salpingectomy was the main surgical method, whereas the adoption of laparotomy and laparoscopic salpingostomy was decreasing year by year.
Although no obvious effect of the two-child policy on EP has been observed under the conditions of this study, the change in EP especially in advanced-age women after the policy implementation needs further evaluation. A decreased caesarean section rate, in primipara is beneficial to reducing the CSP.