THE INFLUENCE OF DEMOGRAPHIC-CHANGE AND CUMULATIVE RISK OF PELVIC INFLAMMATORY DISEASE ON THE INCIDENCE OF ECTOPIC PREGNANCY

A retrospective study was carried out to determine the recent epidemio logy of ectopic pregnancy in England between the biennial years 1988/9 and 1992/3. The number of ectopic pregnancy cases were combined with numbers of conceptions and the rates analysed for trend over time. The incidence of ectopic pregnancy rose significantly (P = 0.05) over thi s period. However, this could be entirely explained by increasing numb ers of births in older women and a highly significant positive associa tion was found between risk of ectopic pregnancy and maternal age (P < 0.0001). Over the study period the incidence of ectopic pregnancy in women aged 40 years or more was over 14 times that observed in those u nder 16 years of age. It is suggested that this reflects cumulative ri sk of acquiring pelvic inflammatory disease. The surveillance of ectop ic pregnancy provides a useful indicator of the level of reproductive morbidity in women.