RISK-FACTORS FOR ECTOPIC PREGNANCY - A CASE-CONTROL STUDY IN RHONE-ALPES AREA (FRANCE)

A case-control study was conducted in 14 Rhone-Alpes area (France) mat ernity hospitals to evaluate the role of several risk factors, particu larly infectious factors, in ectopic pregnancy. A total of 624 cases a nd 1 247 controls were compared for sociodemographic characteristics, cigarette smoking, sexual, reproductive and surgical histories, and co ndition of conception. Different risk factors were found to be associa ted with an increased risk of ectopic pregnancy: pelvic inflammatory d isease confirmed by celioscopy (OR = 3.8, 95 %, Cl = 2.1-6.9), Chlamyd ia trachomatis seropositivity (OR = 4.6, 95 %, Cl = 3.4-6.3), cigarett e smoking at the time of conception with a dose-related effect (OR = 1 .6 to 2.6), prior tubal surgery (OR = 1.8, 95 %, Cl = 1.0-3.1), prior uterus surgery (OR = 3.2, 95 %, Cl = 1.4-7.1), prior ectopic pregnancy (OR = 6.4, 95 %, Cl = 3.6-11.3), induced conception cycle by clomiphe ne citrate (OR = 4.5, 95 %, Cl = 1.7-12.0), endometriosis (OR = 6.7, 9 5 %, Cl = 2.6-17.4) and maternal age, with a strong relation after the age of 35. These findings confirm the major role of pelvic inflammato ry disease which could explain fifty percent of the cases and the one of cigarette smoking at the time of conception which could explain twe nty percent of the cases.