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Current Trends Ectopic Pregnancies -- United States, 1979- 1980

Since 1970, CDC has maintained surveillance of hospitalized patients with ectopic pregnancies and deaths associated with ectopic pregnancies. Data for 1970-1978 have been reported previously (1-3). This report updates information on ectopic pregnancies through 1980. Over the 11-year surveillance period, the rate of ectopic pregnancy in the United States increased almost threefold, from 4.8 per 1,000 live births in 1970 to 14.5/1,000 in 1980 (Table 1).

During 1979, 49,900 ectopic pregnancies were reported. The number increased to 52,200 in 1980. The number of ectopic pregnancies increased annually an average of 11.5% from 1970 to 1978. The average annual increase from 1978 to 1980 was 11.0%. From 1970 to 1980, the rate of ectopic pregnancies per 1,000 reported pregnancies increased more than twofold, from 4.5 to 10.5. During the same period, the death-to-case rate decreased almost fourfold, from 3.5 per 1,000 ectopic pregnancies to 0.9 per 1,000 ectopic pregnancies (Figure 1). Reported by Pregnancy Epidemiology Br, Research and Statistics Br, Div of Reproductive Health, Center for Health Promotion and Education, CDC.

Editorial Note

Editorial Note: CDC obtained data on ectopic pregnancy incidence from the National Hospital Discharge Survey of the National Center for Health Statistics (NCHS). Information on ectopic pregnancy-related deaths was obtained from death certificate data from NCHS before 1979. CDC began active surveillance of ectopic pregnancy-related deaths in 1979.

The overall death-to-case rate fell dramatically from 3.5 per 1,000 ectopic pregnancies in 1970 to 2.0 in 1972; thereafter, the rate dropped more slowly, reaching 0.9 in 1978. Since then, there has been virtually no decrease in the death-to-case rate. An explanation for the reported increase in ectopic pregnancies may be better diagnosis of ectopic pregnancy cases. This increase from 1970 to 1980 may also be due, in part, to a rise in pelvic inflammatory disease, which has occurred during the past two decades in the United States (4).

Preliminary analysis of groups at risk of ectopic pregnancies and of deaths from ectopic pregnancies suggests that trends observed from 1970 to 1978 remained essentially unchanged after 1978. Rates of ectopic pregnancy per 1,000 reported pregnancies were highest among women aged 35-44 years. Rates were higher for black women in all age groups. The rates of ectopic pregnancy were highest in the Northeast and lowest in the South, although the largest number of ectopic pregnancies occurred in the South. The death-to-case rate was highest in the South and lowest in the West. Details of the ages and racial and geographic distributions will be available in a forthcoming issue of CDC's MMWR Surveillance Summaries.

References

  1. CDC. Ectopic pregnancy surveillance. In: Surveillance summaries (published quarterly). February 1983;32 (Suppl. 1):19SS-21SS.

  2. CDC. Ectopic pregnancy surveillance, 1970-1978. Issued July 1982.

  3. Rubin GL, Peterson HB, Dorfman SF, et al. Ectopic pregnancy in the United States 1970 through 1978. JAMA 1983;249:1725-9.

  4. Curran JW. Economic consequences of pelvic inflammatory disease in the United States. Am J Obstet Gynecol 1980;138:848-51.

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