Improving reproductive long-term prognosis for women with a first ectopic pregnancy. A national controlled follow-up study

OBJECTIVE: To describe developments in reproductive long-term prognosis in women with a first ectopic pregnancy as compared with two control cohorts.

DESIGN: Controlled cohort study.

SETTING: Data were collected from four national Danish registries.

POPULATION: All Danish women of reproductive age (15-49 years) through the period 1977-2009 and all reproductive outcomes in these women.

METHODS: Data were collected from four national Danish registries. Three cohorts of women with a first recorded ectopic pregnancy during the periods 1980-84, 1985-89, and 1990-94, were compared with age-matched controls with a first miscarriage and a first induced abortion and followed for 15 years for all further pregnancy outcomes.

MAIN OUTCOME MEASURES: Pregnancy outcomes included deliveries, miscarriages, induced abortions and ectopic pregnancies.

RESULTS: The birth rate for women with a first ectopic pregnancy increased significantly through the three cohorts from 85 to 122 deliveries/100 women during the follow-up period. The risk of miscarriages also increased over time, whereas the risk of further ectopic pregnancies remained unchanged at 22-24 events/100 women. Compared to women with a first miscarriage, the rate ratio for deliveries increased from 0.59 (95% CI 0.56-0.63) to 0.71 (95% CI 0.68-0.75) over the time covering the three cohorts.

CONCLUSION: The long-term delivery rate among women with a first ectopic pregnancy has improved significantly over time.