Contraception and ectopic pregnancy risk: a prospective observational analysis

This study aimed to estimate the rates of ectopic pregnancy in women stratified by contraceptive method used and compare these participants using no or condoms. We hypothesized that highly moderately effective methods (intrauterine device [IUD], implant, injectable contraception, oral contraceptives [OCs], patch, vaginal ring) would have a lower rate than is secondary analysis Contraceptive CHOICE Project (CHOICE), prospective cohort 9256 who were provided their choice at cost observed for duration 2 3 years.1Peipert J.F. Madden T. Allsworth J.E. Secura G.M. Preventing unintended pregnancies providing no-cost contraception.Obstet Gynecol. 2012; 120: 1291-1297Crossref PubMed Scopus (337) Google Scholar Reported incidence during actual use was collected follow-up telephone surveys. estimated each category: copper IUD, levonorgestrel IUD (LNG-IUD), depot medroxyprogesterone acetate (DMPA), 1 combined category consisting OCs, ring. Our control referent group included Inclusion exclusion criteria followed Project.1Peipert The percentages calculated number divided ectopic, specific) multiplied 100. Ectopic per 1000 women-years total length 1000.2Van Den Eeden S.K. Shan J. Bruce C. Glasser M. treatment utilization large managed care organization.Obstet 2005; 105: 1052-1057Crossref (107) Cox proportional hazard models ratios (HRs) condoms group. Participants 20,381 with 13 identified. Follow-up 93.5%, 84.1%, 78.9% 1, 2, years, respectively. Crude results are shown Table. Seven contraception barrier had an pregnancy. There 6 users reported pregnancy; 4 LNG-IUD users, user, OC user. Rates as follows: condoms, 6.90; LNG-IUD, 0.50; 0.46; ring, 0.22; 0; DMPA, 0. Use (HR, 0.06; 95% confidence interval [CI], 0.02–0.23), 0.08; CI, 0.01–0.62), ring 0.04; 0.01–0.37) reduced risk compared condom. choosing implant DMPA pregnancies. Given small events, we only unadjusted HR.TableEctopic HRsMethodNumber pregnanciesaBoth intrauterine numberNumber pregnanciesPercentage pregnanciesWomen-yearsRate women-yearsbThe denominator includes all ectopic).95% CI (rate)HR95% (HR)No condom use51071.3710146.902.7814.22ReferenceLNG-IUD5147.8480600.500.141.270.060.020.23Copper IUD2414.1721980.460.012.530.080.010.62Implant1500.0028860.00—————DMPA3200.0015710.00—————OCs, ring36310.2846520.220.011.200.040.010.37CI, interval; acetate; HR, ratio; device; LNG, levonorgestrel; OC, contraceptive.Schultheis. Contraception risk. Am J Obstet Gynecol 2021.a Both numberb ectopic). Open table new tab contraceptive. Schultheis. 2021. Women significantly contraception. one largest studies investigate across multiple forms covers wider range previous studies, our more contemporary currently literature.3Li Zhao W.H. Zhu Q. et al.Risk factors pregnancy: multi-center case-control study.BMC Pregnancy Childbirth. 2015; 15: 187Crossref (46) Scholar, 4Furlong L.A. when fails. A review.J Reprod Med. 2002; 47: 881-885PubMed 5Li Meng C.X. al.Contraceptive study.PLoS One. 2014; 9: e115031Crossref (17) One limitation work low methods. not unexpected 75% failure. In addition, recall bias possible defining call surveys patient self-report.