Trends in the Diagnosis and Treatment of Ectopic Pregnancy in the United States

To estimate trends in the rates of diagnosis and treatment of ectopic pregnancy in the United States. We analyzed data from a large administrative claims database of more than 200 U.S. commercial health plans, and estimated time trends in the rate and incidence of ectopic pregnancy among girls and w...

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Published inObstetrics and gynecology (New York. 1953) Vol. 115; no. 3; pp. 495 - 502
Main Authors Hoover, Karen W., Tao, Guoyu, Kent, Charlotte K.
Format Journal Article
LanguageEnglish
Published Hagerstown, MD The American College of Obstetricians and Gynecologists 01.03.2010
Lippincott Williams & Wilkins
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Abstract To estimate trends in the rates of diagnosis and treatment of ectopic pregnancy in the United States. We analyzed data from a large administrative claims database of more than 200 U.S. commercial health plans, and estimated time trends in the rate and incidence of ectopic pregnancy among girls and women aged 15-44 years by 5-year age groups and by region from 2002 to 2007. We also estimated time trends in the proportion of cases that were treated surgically, either by laparoscopy or laparotomy, or medically with methotrexate. We identified 11,989 ectopic pregnancies during the period from 2002 to 2007. The overall rate of ectopic pregnancy among pregnant girls and women aged 15-44 years during the 6-year study period was 0.64%. We did not observe a trend in the rate of ectopic pregnancy by 5-year age group or by geographic region. The ectopic pregnancy rate increased with age; it was 0.3% among girls and women aged 15-19 years and 1.0% among women aged 35-44 years. Methotrexate treatment increased from 11.1% in 2002 to 35.1% in 2007 (P<.001); the methotrexate failure rate was 14.7% over the 6-year study period. Surgical management with laparotomy decreased over the study period from 40.0% to 33.1% (P<.001). We did not find an increasing or decreasing trend in the rate of ectopic pregnancy among U.S. commercially insured women from 2002 to 2007. The use of administrative claims data are likely the most feasible method for estimating the rate and monitoring trends of ectopic pregnancy in the United States.
AbstractList To estimate trends in the rates of diagnosis and treatment of ectopic pregnancy in the United States. We analyzed data from a large administrative claims database of more than 200 U.S. commercial health plans, and estimated time trends in the rate and incidence of ectopic pregnancy among girls and women aged 15-44 years by 5-year age groups and by region from 2002 to 2007. We also estimated time trends in the proportion of cases that were treated surgically, either by laparoscopy or laparotomy, or medically with methotrexate. We identified 11,989 ectopic pregnancies during the period from 2002 to 2007. The overall rate of ectopic pregnancy among pregnant girls and women aged 15-44 years during the 6-year study period was 0.64%. We did not observe a trend in the rate of ectopic pregnancy by 5-year age group or by geographic region. The ectopic pregnancy rate increased with age; it was 0.3% among girls and women aged 15-19 years and 1.0% among women aged 35-44 years. Methotrexate treatment increased from 11.1% in 2002 to 35.1% in 2007 (P<.001); the methotrexate failure rate was 14.7% over the 6-year study period. Surgical management with laparotomy decreased over the study period from 40.0% to 33.1% (P<.001). We did not find an increasing or decreasing trend in the rate of ectopic pregnancy among U.S. commercially insured women from 2002 to 2007. The use of administrative claims data are likely the most feasible method for estimating the rate and monitoring trends of ectopic pregnancy in the United States.
Author Tao, Guoyu
Hoover, Karen W.
Kent, Charlotte K.
AuthorAffiliation From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
AuthorAffiliation_xml – name: From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
Author_xml – sequence: 1
  givenname: Karen
  surname: Hoover
  middlename: W.
  fullname: Hoover, Karen W.
  organization: From the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
– sequence: 2
  givenname: Guoyu
  surname: Tao
  fullname: Tao, Guoyu
– sequence: 3
  givenname: Charlotte
  surname: Kent
  middlename: K.
  fullname: Kent, Charlotte K.
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Issue 3
Keywords Treatment
Pregnancy disorders
Gynecology
Trend
Diagnosis
Ectopic pregnancy
Obstetrics
Language English
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Snippet To estimate trends in the rates of diagnosis and treatment of ectopic pregnancy in the United States. We analyzed data from a large administrative claims...
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SubjectTerms Abortifacient Agents - therapeutic use
Adolescent
Adult
Age Distribution
Biological and medical sciences
Diseases of mother, fetus and pregnancy
Female
Gynecology. Andrology. Obstetrics
Humans
Incidence
Medical sciences
Methotrexate - therapeutic use
Pregnancy
Pregnancy, Ectopic - drug therapy
Pregnancy, Ectopic - epidemiology
Pregnancy, Ectopic - surgery
Pregnancy. Fetus. Placenta
United States - epidemiology
Young Adult
Title Trends in the Diagnosis and Treatment of Ectopic Pregnancy in the United States
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https://www.ncbi.nlm.nih.gov/pubmed/20177279
Volume 115
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