Improving reproductive long-term prognosis for women with a first ectopic pregnancy. A national controlled follow-up study

Objective To describe developments in reproductive long-term prognosis in women with a first ectopic pregnancy as compared with two control cohorts. Design Controlled cohort study. Setting Data were collected from four national Danish registries. Population All Danish women of reproductive age (15–49 years) through the period 1977–2009 and all reproductive outcomes in these women. Methods Data were collected from four national Danish registries. Three cohorts of women with a first recorded ectopic pregnancy during the periods 1980–84, 1985–89, and 1990–94, were compared with age-matched controls with a first miscarriage and a first induced abortion and followed for 15 years for all further pregnancy outcomes. Main outcome measures Pregnancy outcomes included deliveries, miscarriages, induced abortions and ectopic pregnancies. Results The birth rate for women with a first ectopic pregnancy increased significantly through the three cohorts from 85 to 122 deliveries/100 women during the follow-up period. The risk of miscarriages also increased over time, whereas the risk of further ectopic pregnancies remained unchanged at 22–24 events/100 women. Compared to women with a first miscarriage, the rate ratio for deliveries increased from 0.59 (95% CI 0.56–0.63) to 0.71 (95% CI 0.68–0.75) over the time covering the three cohorts. Conclusion The long-term delivery rate among women with a first ectopic pregnancy has improved significantly over time.