Luis R Hoyos1, Sejal Tamakuwala2, Anupama Rambhatla3, Harpreet Brar3, Gustavo Vilchez4, Jenifer Allsworth5, Javier Rodriguez-Kovacs6, Awoniyi Awonuga3. 1. Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States; Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States. Electronic address: lhoyosmartinez@mednet.ucla.edu. 2. Department of Obstetrics & Gynecology, Emory University, Atlanta, GA, United States; Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States. 3. Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States. 4. Department of Obstetrics & Gynecology, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States. 5. University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States. 6. Department of Obstetrics & Gynecology, Wayne State University/Hutzel Women's Hospital, Detroit, MI, United States; Department of Obstetrics & Gynecology, University of Chicago, Chicago, IL, United States.
Abstract
OBJECTIVE: To evaluate risk factors for cervical ectopic pregnancies. METHODS: Retrospective, quasi-experimental case-control study of cervical ectopic pregnancy (CEP) cases from 2000-2013. Two groups were selected as controls, patients with tubal ectopic (TEP) and intrauterine pregnancies (IUP) without a history of TEP, matched by year of pregnancy and randomly sampled in a 1:3 case-control ratio per each study group. RESULTS: 21 cases were identified and 126 controls included, 63 TEP and IUP each. A binary logistic regression model was used to analyze whether statistically significant preceding factors from a bivariate analysis could predict CEP. Compared to patients with IUP, CEP patients had a higher history of elective abortions, D&C and cervical excisional procedures, with a high effect size (>0.7). Compared to patients with TEP, CEP patients had a higher history of D&C and cervical excisional procedures, with a high effect size (>.7). The risk of CEP was significantly higher with a prior history of D&C compared to an IUP (aOR 1.4; 95% CI, 1.1-9.1; p=0.04) and a TEP (aOR 6.1; 95% CI, 1.8-21.2; p=0.04). CONCLUSION: D&C is a strong risk factor for CEP when compared to pregnancies in other locations. These findings confirm previous associations described in case series.
OBJECTIVE: To evaluate risk factors for cervical ectopic pregnancies. METHODS: Retrospective, quasi-experimental case-control study of cervical ectopic pregnancy (CEP) cases from 2000-2013. Two groups were selected as controls, patients with tubal ectopic (TEP) and intrauterine pregnancies (IUP) without a history of TEP, matched by year of pregnancy and randomly sampled in a 1:3 case-control ratio per each study group. RESULTS: 21 cases were identified and 126 controls included, 63 TEP and IUP each. A binary logistic regression model was used to analyze whether statistically significant preceding factors from a bivariate analysis could predict CEP. Compared to patients with IUP, CEP patients had a higher history of elective abortions, D&C and cervical excisional procedures, with a high effect size (>0.7). Compared to patients with TEP, CEP patients had a higher history of D&C and cervical excisional procedures, with a high effect size (>.7). The risk of CEP was significantly higher with a prior history of D&C compared to an IUP (aOR 1.4; 95% CI, 1.1-9.1; p=0.04) and a TEP (aOR 6.1; 95% CI, 1.8-21.2; p=0.04). CONCLUSION: D&C is a strong risk factor for CEP when compared to pregnancies in other locations. These findings confirm previous associations described in case series.