Ectopic pregnancy may limit number of subsequent pregnancies

By Piriya Mahendra, medwireNews Reporter

Women whose first pregnancy is ectopic have fewer children in the 20-30 years afterward than those whose first pregnancy ends in a birth, miscarriage, or abortion, show study findings.

Moreover, women whose first pregnancy is ectopic have a 4.7- to 10.0-fold increased risk for having a subsequent ectopic pregnancy, as reported in Human Reproduction.

Women who had a first ectopic pregnancy had the lowest long-term rate of subsequent births (on average 30 years after first pregnancy), at 69 per 100 women, compared with 126 per 100 women among those who had a first miscarriage, 77 per 100 women among those with a first abortion, and 73 per 100 women among those who did not get pregnant in the year the women were matched with each other (controls).

Compared with women who had a first miscarriage, the number of subsequent births among those who had a first ectopic pregnancy was reduced by 45%. Women with a first ectopic pregnancy had a 5% reduction in the number of subsequent births (corresponding to approximately one child less) than those who first pregnancy resulted in a birth.

"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 delivery," commented lead author Line Kårhus in a press statement.

"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."

The number of subsequent births in women with a first ectopic pregnancy was 11% lower than those whose first pregnancy ended in an induced abortion, and 31% lower than those who were not pregnant in the year the different groups of women were matched.

"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," explained Kårhus.

"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."

Compared with women whose first pregnancy ended in miscarriage, those who had a first ectopic pregnancy were 54% less likely to have a subsequent miscarriage and 28% less likely to have an induced abortion.

The researchers suggest that better assisted reproductive techniques developed recently could improve long-term birth rates for women with ectopic pregnancies, and say that this is currently being investigated.

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