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Hum. Reprod. Advance Access originally published online on July 15, 2004
Human Reproduction 2004 19(9):2014-2018; doi:10.1093/humrep/deh399
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Human Reproduction vol. 19 no. 9 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Ectopic pregnancy is again on the increase. Recent trends in the incidence of ectopic pregnancies in France (1992–2002)

Joël Coste1,5, Jean Bouyer1, Sylvie Ughetto2, Laurent Gerbaud2, Hervé Fernandez3, Jean-Luc Pouly4 and Nadine Job-Spira1

1 INSERM U569–IFR 69, Hôpital de Bicêtre, 94276 Le Kremlin-Bicêtre, 2 Service Épidémiologie, Prévention et Économie de la Santé, CHU Clermont-Ferrand, 3 Service de Gynéco-Obstétrique, Hôpital Antoine Béclère, Clamart and 4 Service de Gynéco-Obstétrique, CHU Clermont-Ferrand, France

5 To whom correspondence should be addressed at: Département de Biostatistique, Pavillon Saint-Jacques, Hôpital Cochin, 27, Rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France. Tel: +33 1 58 412021; Fax: +33 1 58 411961; Email: coste{at}cochin.univ-paris5.fr

BACKGROUND: We aimed to assess the recent incidence trends of ectopic pregnancies (EP) in France (1992–2002). METHODS: A population-based register of all women aged 15–44 years with EP was set up in Auvergne (central France). We calculated rates of EP as a ‘reproductive failure’ or as a ‘contraceptive failure’, frequencies of exposure to the two main risk factors for EP (cigarette smoking and chlamydial infection) and contraceptive methods between 1992 and 2002. RESULTS: The overall EP rate decreased by 2%, from 96.4 per 100 000 women aged 15–44 in 1992 to 95.3 per 100 000 in 2002. However, the rate of ‘reproductive failure’ EP increased by 17%, while the rate of ‘contraceptive failure’ EP, mostly intrauterine device failure, decreased by 29%. CONCLUSION: Appropriate analysis reveals that the rate of EP as reproductive failure is increasing again in France. This result is of interest for many European and North America countries where chlamydial infections or smoking or both are increasing in women of reproductive age. The rates of EP as contraceptive failure and of that as reproductive failure evolve differently in the population and should not be confused in epidemiological studies.

Key words: contraception/ectopic pregnancy/epidemiology/intrauterine device/reproduction failure


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I.J. Bakken and F.E. Skjeldestad
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