Portrait des grossesses ectopiques au Québec et leurs retombées sur la santé reproductive
Introduction: The number of ectopic pregnancies has increased in the Occident. In order to stop the increase, studies have focused on risk factors for ectopic pregnancy. However, little is known about the future reproductive and maternal health of women with ectopic pregnancy.  Objectives: The objective of this study is to characterize ectopic pregnancies in Quebec from 1989 to 2014. It aims to assess the association between ectopic pregnancy and adverse outcomes in future pregnancies. In addition, this study aims to identify risk factors for ectopic pregnancy.  Methods: This study is a longitudinal cohort study that was carried out in Quebec, Canada, from 1989 to 2014. We followed women who were hospitalised for an ectopic pregnancy or a delivery in Quebec for a maximum period of 25 years. Log-binomial regressions were performed to calculate relative risks of adverse outcomes in next pregnancy among women with ectopic versus no ectopic pregnancy. Finally, we calculated the relative risk of an ectopic pregnancy for women with a prior adverse pregnancy outcome vs. no prior adverse outcome.  Discussion: Women with an ectopic pregnancy are older, had at least three previous pregnancies, do not have any comorbidities, and were less likely to be hospitalised after 2010. At next successful pregnancy, women with a previous ectopic pregnancy have a higher risk of preterm birth, low and very low birth weight, caesarean, placental abruption, severe maternal morbidity, antepartum hemorrhage, and multiple birth. Finally, preterm birth, low and very low birth weight, caesarean, placental abruption, severe maternal morbidities, antepartum hemorrhage and multiple birth are risk factors for ectopic pregnancy.  Conclusion: Women with ectopic pregnancy may benefit from counselling to improve future pregnancy outcomes.
Ectopic pregnancy Maternal health Reproductive health Perinatality