CONTRACEPTION AND THE RISK OF ECTOPIC PREGNANCY - A METAANALYSIS

The current knowledge of the association between contraceptive methods and the risk of ectopic pregnancy was evaluated by means of a meta-an alysis. Case-control and cohort studies published between 1978 and 199 4 in English, French, German and Dutch were retrieved by a search in M edline, a hand-search on recent medical journals and cross-references. Papers reporting on the association between contraceptives and ectopi c pregnancy were judged according to predefined entrance criteria conc erning selection of control groups, and retractability of raw data ena bling the calculation of crude odds ratios. Common Odds Ratios (COR) a nd 95% confidence intervals were calculated if homogeneity was not rej ected. Twelve case-control studies and one cohort study were detected. CORs could be calculated for current and past use of oral contracepti ves, past IUCD use and tubal sterilization. All assessed contraceptive s protect against ectopic pregnancy. Women becoming pregnant after ste rilization or while currently using an IUCD are at an increased risk. The IUCD is the only contraceptive method associated with an increased risk after discontinuation of its use.