Ectopic pregnancy risk factors
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Moises Romo M.D.
Overview
There are a number of risk factors for ectopic pregnancies. They include: pelvic inflammatory disease, infertility, those who have been exposed to DES, tubal surgery, smoking, previous ectopic pregnancy, multiple sexual partners, current IUD use, tubal ligation, and previous abortion.[1]
Risk Factors
- Although tubal ligation prevents pregnancies, if a pregnancy does occur, it is more likely to be ectopic.
- The risk of EP increases in women who have had prior ectopics, but decreases for each subsequent intrauterine pregnancy.
- Diethylstilbestrol (DES) causes a loss of fimbriae, a small opening, and fallopian tubes that are shorter and thinner than normal.
- Infertility primarily increases the risk of EP during treatment – IVF (in vitro fertilization) is associated with a 2 – 3 % increased risk compared with the general population.
| Risk Factor | Odds Ratio |
| Tubal surgery | 21 |
| Tubal ligation | 9.3 |
| Previous ectopic | 8.3 |
| In-utero DES exposure | 5.6 |
| IUD | 4.2 – 45 |
| Documented tubal pathology | 3.8 – 21 |
| Moderate Risk | |
| Infertility | 2.5 – 21 |
| Previous STD | 2.5 – 3.7 |
| Multiple sexual partners | 2.1 |
| Low Risk | |
| Prior pelvic / abd surgery | 0.9 – 3.8 |
| Cigarette smoking | 2.3 – 2.5 |
| Vaginal douching | 1.1 – 3.1 |
| 1st intercourse < 18 years old | 1.6 |
Patients are at higher risk for ectopic pregnancy with advancing age. Also, it has been noted that smoking is associated with ectopic risk. Vaginal douching is thought by some to increase ectopic pregnancies; this is speculative. Women exposed to diethylstilbestrol (DES) in utero (aka "DES Daughters") also have an elevated risk of ectopic pregnancy, up to 3 times the risk of unexposed women.