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Observational Study
. 2023 Oct 26;18(10):e0291316.
doi: 10.1371/journal.pone.0291316. eCollection 2023.

Global burden and trends of ectopic pregnancy: An observational trend study from 1990 to 2019

Shufei Zhang  1 , Jianfeng Liu  1 , Lian Yang  1 , Hanyue Li  1 , Jianming Tang  1 , Li Hong  1
Affiliations
Observational Study

Global burden and trends of ectopic pregnancy: An observational trend study from 1990 to 2019

Shufei Zhang et al. PLoS One. .

Abstract

Background: Ectopic pregnancy (EP) is one of the leading causes of death in women in early pregnancy, and the mortality of EP have gradually decreased over time in developed countries such as the United Kingdom and the United States. However, epidemiological information on EP has been lacking in recent years, so we analyzed EP data over a thirty-year period from 1990-2019 with the help of Global Burden of Disease study (GBD) data to fill this gap.

Methods: According to the EP data in GBD for the three decades from 1990 to 2019, we used estimated annual percentage changes (EAPC) to assess the trend of age-standardized incidence rate (ASIR), age-standardized death rate (ASDR) and age-standardized disability adjusted life years (AS-DALYs) trends in EP and to explore the correlation between socio-demographic index (SDI) stratification, age stratification and EP.

Results: Global ASIR, ASDR, AS-DALYs for EP in 2019 are 170.33/100,000 persons (95% UI: 133.18 to 218.49), 0.16/100,000 persons (95% UI, 0.14 to 0.19) and 9.69/100,000 persons (95% UI, 8.27 to 11.31), respectively. At the overall level, ASDR is significantly negatively correlated with SDI values (R = -0.699, p < 0.001). Besides that, ASDR and AS-DALYs have basically the same pattern. In addition, iron deficiency is one of the risk factors for EP.

Conclusions: In the past three decades, the morbidity, mortality and disease burden of EP have gradually decreased. It is noteworthy that some economically disadvantaged areas are still experiencing an increase in all indicators, therefore, it is more important to strengthen the protection of women from ethnic minorities and low-income groups.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1
Distribution of (A) ASIR, (B) ASDR, (C) AS-DALYs and (D) EAPC-ASIR in various countries and regions in 2019.
Fig 2
Fig 2. Distribution of incidence rate in different SDI regions, age distribution of incidence rate in different SDI regions from 1990–2019.
Fig 3
Fig 3. Cluster analysis of incidence rate and death rate in different countries.
Fig 4
Fig 4
Correlation analysis. (A) The correlation between EAPC and ASIR/ASDR in 2019. (B) ASIR for EP for different regions and (C) countries and territories by SDI, 1990–2019.
Fig 5
Fig 5. Proportion of EP deaths and DALYs attributable to iron deficiency for different SDI regions, 2019.
See this image and copyright information in PMC

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