Ectopic pregnancy in the United States 1979-1980.

Data from the National Hospital Discharge Survey conducted by the US National Center for Health Statistics indicate that there was a 2.9-fold increase in the incidence of ectopic pregnancy in the US between 1970-80. A total of 363700 ectopic pregnancies were reported for this period with an overall rate of 7.8/1000 reported pregnancies. The number of reported ectopic pregnancies rose from 42400 (9.4/1000) in 1978 to 522000 (10.5/1000) in 1980. The risk of ectopic pregnancy increased with age with rates of 5.1/1000 for women 15-24 years 10.5/1000 for those 25-34 years and 16.0/1000 for those 35-44 years. Although 71% of ectopic pregnancies in 1970-80 involved white women the rates were higher for black women in each age group and almost double the rates for white women in the 25-34 and 35-44 age groups. Overall rates were similar in all 4 geographic regions of the US with the highest rates occurring in the Northeast and the lowest rates recorded in the South. The mean length of hospital stay for ectopic pregnancy fell from 7.2 days in 1970 to 5.8 days in 1977 and has remained at the same level since then. A total of 524 woman died from ectopic pregnancies in 1970-80. The overall death-to-case rate dropped from 0.9 deaths/1000 ectopic pregnancies in 1978 to 0.8 in 1979 and rose again to 0.9 in 1980. The mortality rate is similar in all age groups with an overall rate of 1.4 deaths/1000 ectopic pregnancies. The death-to-case rate for black women was 3.6 times that of white women. The increase in ectopic pregnancy incidence noted during the 1970s may be related to the increase in pelvic inflammatory disease. Differences in the availability and utilization of medical care between blacks and whites may account for the higher death-to-case rates among black women.