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Current Trends Ectopic Pregnancy -- United States, 1981-1983

During 1981, 68,000 ectopic pregnancies were reported in the United States; the number decreased to 61,800 in 1982 and increased again to 69,600 in 1983 (Table 1). Over the 14-year surveillance period of 1970-1983, the rate of ectopic pregnancy increased more than threefold from 4.5 per 1,000 pregnancies* in 1970 to 14.0/1,000 in 1983 (Table 1, Figure 1). The rate per 1,000 live births increased fourfold from 4.8 in 1970 to 19.2 in 1983, and the rate per 10,000 females 15-44 years of age increased threefold from 4.2 to 12.6 during 1970-1983. The mortality rate continued to decrease from 0.9/1,000 ectopic pregnancies in 1980 to 0.5/1,000 in 1983 (Figure 2).

Preliminary analysis has revealed that for 1981-1983, as for 1970-1980, the highest rates of ectopic pregnancy were among women 35 years of age or older and among women of black and other races. However, unlike 1970-1980, when the highest rates of ectopic pregnancy occurred in the Northeast and the lowest occurred in the South, during 1981-1983, the highest rates were in the West, and the lowest, in the Northeast.

As in 1970-1980, in 1981-1983 there was no substantial difference in the risk of dying from ectopic pregnancy among women of different age groups. The mortality rate was highest in the South and lowest in the West. However, women of black and other races had a threefold higher risk of death from ectopic pregnancy than white women, compared with a 3.6-fold higher risk during 1970-1980. 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 has previously reported on ectopic pregnancy in the United States for 1970-1980 (1). Data on ectopic pregnancy incidence were obtained from the National Hospital Discharge Survey of the National Center for Health Statistics. The increasing incidence of ectopic pregnancy is probably related to improved diagnostic technology, as well as to an increased incidence of pelvic inflammatory disease (2). There is no ready explanation for the out-of-proportion increase in the number and rate of ectopic pregnancies in 1981.

Ectopic pregnancy mortality data for 1979-1982 were obtained from CDC's Ectopic Pregnancy Mortality Surveillance. For the other years, mortality data were obtained from death certificate data from NCHS. Numbers from those two sources have been found to be comparable.

Mortality due to ectopic pregnancy dropped dramatically in the early 1970s and more slowly during the recent years (Figure 2). Overall, the mortality rate decreased sevenfold from 3.5 deaths/1,000 ectopic pregnancies in 1970 to 0.5/1,000 in 1983.

References

  1. MacKay HT, Hughes JM, Hogue CJR. Ectopic pregnancy in the United States, 1979-1980. In: CDC surveillance summaries. Atlanta, Georgia: Centers for Disease Control, 1984;33(No. 2SS):1SS-7SS.

  2. Washington AE, Cates W Jr, Zaidi AK. Hospitalizations for pelvic inflammatory disease: epidemiology and trends in the United States, 1975 to 1981. JAMA 1984;251:2529-33.

    • Includes ectopic pregnancies, legally induced abortions, and live births.



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