Background: In recent years, epidemiological data showed that the incidence of ectopic pregnancies (EP) is decreasing, but few data are available on the time trend in Southern European populations. Methods: Using data from the Lombardy Region Database, we calculated and standardized the EP rates/10,000 resident women and the ratios/1,000 pregnancies. Results: Data regarding 1,777,011 pregnancies and 17,028 cases of EP were recorded among women resident in Lombardy between 1996 and 2010, aged 15-50 years old. The age-adjusted EP rates increased from 4.4 in 1996 to 5.8 in 2010. The age-adjusted EP ratio was 9.4/1,000 pregnancies in 1996 and 9.8 in 2010. Medical treatment increased over the period; the proportion of laparoscopic treatment increased from 25.9% in 1996 to 36.3% in 2010. Conclusion: The age-adjusted EP rate and ratio increased between 1996 and 2010, suggesting that the significance of EP as a public health problem has increased in the last years.

Keywords:
Ectopic pregnancy, Epidemiology
1.
Varma R, Gupta J: Tubal ectopic pregnancy. Clin Evid (Online) 2009;pii:1406.
2.
Storeide O, Veholmen M, Eide M, Bergsjo P, Sandvei R: The incidence of ectopic pregnancy in Hordaland County, Norway 1976-1993. Acta Obstet Gynecol Scand 1997;76:345-349.
3.
Rajkhowa M, Glass MR, Rutherford AJ, Balen AH, Sharma V, Cuckle HS: Trends in the incidence of ectopic pregnancy in England and Wales from 1966 to 1996. Br J Obstet Gynaecol 2000;107:369-374.
4.
Makinen J: Ectopic pregnancy falls in Finland. Lancet 1996;348:129-130.
5.
Flett GM, Urquhart DR, Fraser C, Terry PB, Fleming JC: Ectopic pregnancy in Aberdeen 1950-1985. Br J Obstet Gynaecol 1988;95:740-746.
6.
Westrom L, Bengtsson LP, Mardh PA: Incidence, trends, and risks of ectopic pregnancy in a population of women. BMJ (Clin Res Ed) 1981;282:15-18.
7.
Bakken IJ, Skjeldestad FE: Time trends in ectopic pregnancies in a Norwegian county 1970-2004 - a population-based study. Hum Reprod 2006;21:3132-3136.
8.
Boufous S, Quartararo M, Mohsin M, Parker J: Trends in the incidence of ectopic pregnancy in New South Wales between 1990-1998. Austr NZ J Obstet Gynaecol 2001;41:436-438.
9.
De Rosnay P, Irvine LM: An ‘epidemic' of ectopic pregnancy in West Hertfordshire, UK? J Obstet Gynaecol 2010;30:179-183.
10.
Hoover KW, Tao G, Kent CK: Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol 2010;115:495-502.
11.
Van Den Eeden SK, Shan J, Bruce C, Glasser M: Ectopic pregnancy rate and treatment utilization in a large managed care organization. Obstet Gynecol 2005;105:1052-1057.
12.
Egger M, Low N, Smith GD, Lindblom B, Herrmann B: Screening for chlamydial infections and the risk of ectopic pregnancy in a county in Sweden: ecological analysis. BMJ 1998;316:1776-1780.
13.
Kamwendo F, Forslin L, Bodin L, Danielsson D: Epidemiology of ectopic pregnancy during a 28 year period and the role of pelvic inflammatory disease. Sex Transm Infect 2000;76:28-32.
14.
Coste J, Bouyer J, Ughetto S, Gerbaud L, Fernandez H, Pouly JL, et al: Ectopic pregnancy is again on the increase. Recent trends in the incidence of ectopic pregnancies in France (1992-2002). Hum Reprod 2004;19:2014-2018.
15.
Eurostat: Total fertility tables. http://epp.eurostat.ec.europa.eu/tgm/table.do?tab=table&init=1&plugin=0&language=en&pcode=tsdde220 (last accessed October 4, 2012).
16.
Parazzini F, Bulfoni G, Cipriani S, Ricci E: Obstetric admissions in Lombardy hospitals, 2008. It J Gynaecol Obstet 2010;22:13-31.
17.
Parazzini F, La Vecchia C, Fasoli M, Cecchetti G, Mezzanotte G: Trends in ectopic pregnancies and use of intrauterine devices in Lombardy, Italy 1979-1983. Contraception 1988;37:29-38.
18.
ISTAT: Population by sex and age at 1st of January, 1992-2001, and population residing in Lombardy by age, sex and marital status at 1st of January, 2002-2011. http://demo.istat.it (last accessed June 4, 2012).
19.
Shaw JL, Dey SK, Critchley HO, Horne AW: Current knowledge of the aetiology of human tubal ectopic pregnancy. Hum Reprod Update 2010;16:432-444.
20.
Yao M, Tulandi T: Current status of surgical and nonsurgical management of ectopic pregnancy. Fertil Steril 1997;67:421-433.
21.
Mol BW, Matthijsse HC, Tinga DJ, Huynh T, Hajenius PJ, Ankum WM, et al: Fertility after conservative and radical surgery for tubal pregnancy. Hum Reprod 1998;13:1804-1809.
22.
Ministero della Salute: Relazione del Ministro del Lavoro, della Salute e delle Politiche Sociali al Parlamento sullo stato di attuazione della legge contenente norme in materia di procreazione medicalmente assistita (legge 19 febbraio 2004, n.40, articolo 15). Attività anno 2008. http://www.iss.it/binary/rpma/cont/relazione_PARLAMENTO_30giu2010.pdf (last access June 4, 2012).
23.
Gallus S, Tramacere I, Pacifici R, Zuccaro P, Colombo P, Ghislandi S, et al: Smoking in Italy 2008-2009: a rise in prevalence related to the economic crisis? Prev Med 2011;52:182-183.
24.
Salfa MC, Regine V, Ferri M, Pugliese L, Suligoi B: Sexually transmitted disease surveillance in a network of clinic centres: 18 years of activity. Notiziario Istituto Superiore di Sanità 2012;25:3-10. http://www.iss.it/binary/ccoa/cont/Notiziario_Istituto_Superiore_di_Sanit_2012.pdf_25_2_pp.3_10.pdf (last accessed October 6, 2012).
25.
Parazzini F, Foschi R, Bertuccio P, Chiaffarino F, Cipriani S, Chatenoud L: Health in pregnancy: an overview. Riv Ost Gin Prat Med Perinat 2010;XXV:12-39.
26.
de Bennetot M, Rabischong B, Aublet-Cuvelier B, Belard F, Fernandez H, Bouyer J, Canis M, Pouly JL: Fertility after tubal ectopic pregnancy: results of a population-based study. Fertil Steril 2012;98:1271-1276.e1-e3.
27.
Trabert B, Holt VL, Yu O, Van Den Eeden SK, Scholes D: Population-based ectopic pregnancy trends, 1993-2007. Am J Prev Med 2011;40:556-560.
© 2013 S. Karger AG, Basel
2013
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.