4.4 Article

Ectopic pregnancy: perinatal outcomes of future gestations and long-term neurological morbidity of the offspring

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ARCHIVES OF GYNECOLOGY AND OBSTETRICS
卷 304, 期 3, 页码 633-640

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SPRINGER HEIDELBERG
DOI: 10.1007/s00404-021-05991-2

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Cerebral palsy; Ectopic pregnancy; Neurological morbidity; Pregnancy outcomes; Preterm birth; Subsequent pregnancy

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The study showed that mothers with a history of ectopic pregnancy are at higher risk for preterm delivery, but their offspring are not at increased risk for long-term neurological morbidity.
Purpose To evaluate perinatal outcomes and long-term neurological morbidity of offspring to mothers with a history of ectopic pregnancy. Methods In this retrospective study, perinatal outcomes and long-term neurological morbidity of offspring were assessed among mothers with a history of ectopic pregnancy, either medically or surgically treated. The study groups were followed until 18 years of age for neurological-related morbidity. For perinatal outcomes, generalized estimated equation (GEE) models were used to control for confounders. A Kaplan-Meier survival curve was used to compare cumulative neurological morbidity incidence and Cox proportional hazards model was conducted to control for confounders. Results A total of 243,682 mothers were included; 1424 mothers (0.58%) had a previous ectopic pregnancy, of which 25.6% (n = 365) were treated medically, and 74.3% (n = 1059) were treated surgically. Using GEE models, controlling for confounders, both surgically and medically treated ectopic pregnancies were noted as independent risk factors for preterm delivery in the subsequent pregnancies. Maternal history of surgically treated ectopic pregnancy was also independently associated with cesarean delivery. Offspring to mothers with previous ectopic pregnancy had comparable rates of long-term neurological morbidity. In the Cox proportional hazards model, controlling for confounders, being born to a mother with a history of previous ectopic pregnancy was not found to be independently associated with long-term neurological morbidity of offspring. Conclusions Maternal history of ectopic pregnancy is independently associated with preterm delivery. However, offspring of mothers with a history of ectopic pregnancy are not at an increased risk for long-term neurological morbidity.

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