Women whose first pregnancy was ectopic have fewer children
Women whose first pregnancy is ectopic are likely to have fewer children in the following 20-30 years than women whose first pregnancy ends in a delivery, miscarriage or abortion, according to results from a study of nearly 3,000 women in Denmark. In addition, these women have a five-fold increased risk of a subsequent ectopic pregnancy.
The first study to look at long-term reproductive outcomes in women whose first pregnancy was ectopic is published online today (Thursday) in Europe's leading reproductive medicine journal Human Reproduction.
Ectopic pregnancies are pregnancies where a fertilised egg implants somewhere other than the lining of the womb; often it's in one of the Fallopian tubes. Approximately one per cent of pregnancies are ectopic, and they are never viable; often the eggs die, sometimes a drug called methotrexate is given so that the pregnancy tissue is absorbed into the woman's body, and sometimes surgery is needed.
Although it is already known that a previous ectopic pregnancy can increase the risk of a subsequent one, most studies have been small and with short follow-up. "We found no controlled study assessing long-term reproductive prognosis in women whose first pregnancy is ectopic," write the authors of the current study.
The researchers collected data from four Danish registries covering the period 1977-2009. They found 2,917 women whose first pregnancy was ectopic between 1977-1982 and who, except for those who died or emigrated, were followed to the end of 2009 or for an average of 23 years.
These women were matched with other women of the same age whose first pregnancy resulted in a delivery, miscarriage or abortion. They were also compared with a fourth group of women who had no recorded pregnancy in the year of matching.
Dr Line Lund Kårhus (MD), a research student in the Gynaecological Clinic at the Rigshospitalet in Copenhagen, Denmark, said: "We found that the group of women who had a first ectopic pregnancy had the lowest delivery rate and total number of pregnancies over the following 20-30 years when compared with the other groups, and also lower rates of miscarriages and abortions. They had a 4.7-10-fold increased risk of further ectopic pregnancies."
Women who had had an ectopic pregnancy had the lowest long-term rate of subsequent deliveries of 69 per 100 women, compared with 126 per 100 among women who had a first miscarriage, 77 per 100 among women who had a first abortion, 73 per 100 among women whose first pregnancy ended in a delivery, and 101 per 100 among the women who were not pregnant in the year the women were matched with each other.
Compared to women who had a first miscarriage, the number of subsequent deliveries among the women who had a first ectopic pregnancy was reduced by nearly a half (45%). When compared with women whose first pregnancy resulted in a delivery, there was no statistically significant difference: the women in the ectopic pregnancy group had a slightly reduced (5%) number of subsequent pregnancies, ending up with approximately one child less during the follow-up period.
"It is not surprising that there was little difference between the women who had an ectopic pregnancy and women who delivered a baby from their first pregnancy," said Dr Kårhus. "We think women with a first ectopic pregnancy have to try harder to achieve the number of deliveries they wish. However, their attempts are counterbalanced by the fact they are less fertile, and, therefore, ultimately they end up with one less birth."
When compared to women whose first pregnancy ended in an induced abortion or who were not pregnant in the year the different groups of women were matched, the number of subsequent deliveries among women in the ectopic pregnancy group was reduced by 11% and 31% respectively.
"These results indicate that fertility is compromised in women whose first pregnancy is ectopic and even after 30 years they have significantly fewer children compared with other women," she said. "We had expected that, over time, women would compensate for their reduced fertility by making more attempts to become pregnant. However, our results demonstrate that these extra attempts at pregnancy do not result in the same number of babies for women whose first pregnancy was ectopic compared with other women."
The study also showed that women in the ectopic pregnancy group were less likely to have a subsequent miscarriage or an induced abortion – a 54% and 28% reduced risk respectively – when compared with women whose first pregnancy ended in miscarriage.
The researchers say that it is possible that better assisted reproductive techniques that have been developed in recent years could improve the long-term delivery rates for women with ectopic pregnancies, and this is under current investigation.
More information: "Long-term reproductive outcomes in women whose first pregnancy is ectopic: a national controlled follow-up study", by Line Lund Kårhus, Pia Egerup, Charlotte Wessel Skovlund, and Øjvind LIdegaard. Human Reproduction journal. doi:10.1093/humrep/des375
Journal reference: Human Reproduction
- Future reproductive outcomes for women who have had an ectopic pregnancy Jun 20, 2012 | not rated yet | 0
- Research gives insights into abortion Sep 05, 2012 | not rated yet | 0
- New biomarker may help diagnose ectopic pregnancies Nov 04, 2010 | not rated yet | 0
- Discovery of blood proteins that are red flags for ectopic pregnancy Feb 16, 2011 | not rated yet | 0
- Annual sonograms are needed to verify correct IUD position, obstetricians say Mar 29, 2011 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Image of a Convex Lens Cut in Half Horizontally
45 minutes ago Hello everyone, A friend of mine came up with this question in class and I really do not have a good answer. Suppose you have a convex lens...
Ray tracing throught optical system of thick lenses
54 minutes ago Can you advise me a free software that allow to draw rays passed throught system of thick lenses (preferable in 3D)?
Faraday's law on circular wire
1 hour ago In my examples on Faraday's law in my book, they use a drawing of a magnet approaching a circular wire. The changing magnetic flux then induces an...
Specific Exergy vs Specific Flow Exergy
3 hours ago I'm having some difficulty understanding exactly what the difference between the definitions of these values are. As I understand it, in terms of...
The Durability of Bone: Long Falls
11 hours ago I am doing a paper on the physics in Valve's Portal and got interested in the "Long Fall Boots" that prevent any damage no matter how far you fall. I...
Is energy convertible to matter?
13 hours ago Can we convert energy to matter?
- More from Physics Forums - Classical Physics
More news stories
A study of around 1,000 UK mothers and their children, published in The Lancet, has revealed that iodine deficiency in pregnancy may have an adverse effect on children's mental development. The research raises concerns that t ...
Obstetrics & gynaecology 15 hours ago | not rated yet | 0
Nearly three out of four pregnant women experience constipation, diarrhea or other bowel disorders during their pregnancies, a Loyola University Medical Center study has found.
Obstetrics & gynaecology May 20, 2013 | not rated yet | 0
New research indicates that women's reproductive function may be tied to their immune status. Previous studies have found this association in human males, but not females.
Obstetrics & gynaecology May 17, 2013 | not rated yet | 0 |
Elsevier today announced the publication of a recent study in Reproductive BioMedicine Online on 5-day old human blastocysts showing that those with an abnormal chromosomal composition can be identified by the rate at whic ...
Obstetrics & gynaecology May 16, 2013 | not rated yet | 0
While global attention has for decades been focused on reducing maternal mortality, population-based data on other causes of death among women of reproductive age has been virtually non-existent. A study conducted by researchers ...
Obstetrics & gynaecology May 14, 2013 | not rated yet | 0
(Medical Xpress)—A report published today shows a 2.6% decrease in the amount of alcohol sold per adult in Scotland in the year following the introduction of the Alcohol etc. (Scotland) Act in October 2011.
53 minutes ago | not rated yet | 0
(Medical Xpress)—High blood pressure is something that has traditionally been a problem in Scotland, but might there be a link to our climate?
43 minutes ago | not rated yet | 0
(Medical Xpress)—Health care spending is much higher for older Americans than for younger adults and children, on average, and analysts have said that increasing spending leads to longer life expectancy.
33 minutes ago | not rated yet | 0
The DESolve bioresorbable coronary scaffold system achieves good efficacy and safety with low rates of late lumen loss and major coronary adverse events at six months, show first results from the pivotal DESolve Nx trial ...
14 minutes ago | not rated yet | 0
More than 40 percent of patients being treated for COPD at a federally funded clinic did not have the disease, researchers found after evaluating the patients with spirometry, the diagnostic "gold standard" for chronic obstructive ...
13 minutes ago | not rated yet | 0
Results from a large observational study reported at EuroPCR 2013 today question whether bivalirudin is superior to heparin in the absence of GPIIb/IIIa blockade, showing similar 30-day mortality in patients with non-ST segment ...
13 minutes ago | not rated yet | 0