Journal of Pediatric and Adolescent Gynecology
Volume 20, Issue 3 , Pages 181-185, June 2007

Risk Factors for Ectopic Pregnancy: A Comparison Between Adults and Adolescent Women

  • Seema Menon, MD

      Affiliations

    • Penn Fertility Care, Dept of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    • Corresponding Author InformationAddress reprint requests to: Seema Menon, MD, Penn Fertility Care, Department of Obstetrics & Gynecology, University of Pennsylvania Medical Center, 3701 Market Street – Suite 810, Philadelphia, PA 19104
  • ,
  • Mary D. Sammel, ScD

      Affiliations

    • Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    • Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  • ,
  • Michelle Vichnin, MD

      Affiliations

    • Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  • ,
  • Kurt T. Barnhart, MD, MSCE

      Affiliations

    • Penn Fertility Care, Dept of Obstetrics & Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
    • Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA

Abstract 

Purpose

To compare the prevalence of classical risk factors and presenting signs and symptoms between adolescents and adults with ectopic pregnancy (EP).

Procedure

A database containing information regarding presentation symptoms, past medical history, and ultimate pregnancy outcomes of patients presenting to the Emergency Department during early pregnancy is maintained in our institution. Data were extracted and analyzed for all patients ultimately diagnosed with EP. Patients were separated into adult (≥20 years of age) and adolescent groups (<20 years of age). Adjusted comparisons were made between these two groups regarding pain, vaginal bleeding, current and past pelvic infections, prior pregnancy history, and prior surgery using Pearson's chi-square, t test, and multivariable models.

Results

The incidence of EP was lower in the adolescent group versus the adult group (9.7% versus 21.7%). Classical risk factors such as prior EP (P < 0.01), and prior pelvic surgery (P < 0.01) were significantly more likely to be associated with adults than adolescents with EP. Adolescent patients were significantly more likely to present with abdominal pain (P = 0.045) and current gonorrhea and/or chlamydia (gc/ct) infection (P < 0.01).

Conclusions

This preliminary study suggests that different risk factors may be associated with EP in adolescents compared to adults.

Key Words: Adolescents, Teenagers, Ectopic pregnancy, Risk factors

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PII: S1083-3188(07)00036-8

doi:10.1016/j.jpag.2007.01.007

Journal of Pediatric and Adolescent Gynecology
Volume 20, Issue 3 , Pages 181-185, June 2007