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
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.
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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