Ectopic pregnancy epidemiology and demographics

Ectopic pregnancy remains an important cause of death among all pregnancies. Drug abuse, unmarried status, no insurance, and had less than a high school education are factors associated with higher incidence of death. Ectopic pregnancies compose 1-2% of all pregnancies worldwide. In The United States, the incidence of ectopic pregnancy is 197 new cases per 100,000 persons. White females are more commonly affected, although, mortality rate is higher in those of black race.

• Ectopic pregnancy is a disease of short duration, immediately approached, hence difficult to calculate its prevalence.
• Around 1 in every 50 pregnancies in The United States are ectopic pregnancies.^[1]

• Worldwide, ectopic pregnancies occur in 1-2% of all pregnancies.
• In developing countries, the incidence of ectopic pregnancies range between 0.4% of all pregnancies in places such as Middle East and India, and over 4% reported in certain African countries, such as Ghana.
• In developed countries, such as The United States, the incidence of ectopic pregnancy is 197 new cases per 100,000 persons.
• Ectopic pregnancies are though to be as high as 4% in pregnancies involving assisted reproductive technology.^[2]

• Ectopic pregnancies account for 3-4% of all pregnancy-related deaths in The United States.^[3]
• Case-fatality rate has greatly decreased in The United States in the last decades, from 1.2 per 100,000 live births in 1980 to 0.5 per 100,000 live births in 2007.^[4]
• Among the deaths from ectopic pregnancies in hospitalized women between 1998 and 2007, 70.5% were tubal pregnancies.^[5]
• In lately years (2008-2010), from the women who died from ectopic pregnancies, 1.8 deaths per 100,000 live births died from hypovolemic shock from hemorrhage as compared with 0.3 deaths per 100,000 live births in 1999-2008.^[6]

• The rate of ectopic pregnancies is higher in women aged between 35-44.^[7]
• Ectopic pregnancy mortality ratio was 3.5 times higher for women older than 35 years than those younger than 25 years during 2003-2007 in The United States.^[5]

• Ectopic pregnancies, are unique to female gender.

• Ectopic pregnancies usually affects women of black race more than others.^[8] Asian women are less likely to develop ectopic pregnancies.^[9]
• Ectopic pregnancy mortality ratio was 6.8 times higher in African Americans than their whites counterparts during 2003-2007 in The United States.^[5]

• Drug abuse, unmarried status, no insurance, and had less than a high school education were factors associated with higher incidence of death in patients with ectopic pregnancies.^[6]
• A previous ectopic pregnancy, increases the risk of a second ectopic pregnancy by 15%.

• In most of European countries and North America, the incidence of ectopic pregnancy has tripled over the past 30 years.^[10]
• In developed countries, tubal damage resulting from infection or surgery, previous ectopic pregnancy, history of secondary infertility and treatment for in-vitro fertilization are rising risk factors for ectopic pregnancy.^[11]

• The diagnosis of ectopic pregnancy is especially challenging in developing countries before 7 weeks of amenorrhea, due to the poor access to ultrasound scans. It is often confused with miscarriage or induced abortion, an ovary problem, or with a PID.^[12]
• In developing countries, surgery remains the mainstay of treatment, mostly performed by laparotomy rather than by laparoscopy.^[12]

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