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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
CDC. Ectopic pregnancy surveillance. In: Surveillance
summaries
(published quarterly). February 1983;32 (Suppl. 1):19SS-21SS.
CDC. Ectopic pregnancy surveillance, 1970-1978. Issued July
1982.
Rubin GL, Peterson HB, Dorfman SF, et al. Ectopic pregnancy in
the United States 1970 through 1978. JAMA 1983;249:1725-9.
Curran JW. Economic consequences of pelvic inflammatory
disease
in the United States. Am J Obstet Gynecol 1980;138:848-51.
Disclaimer
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