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

Abstract

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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Acknowledgements

This study was conducted as part of the requirements for MD degree from the Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev.

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Authors

Contributions

Ms. MR: Writing original draft, visualization; Dr. TW: Data analysis, conceptualization, development or design of methodology, validation, writing review and editing; Prof. ES: Conceptualization, writing review and editing, supervision; Mr. TL: Writing review and editing; Dr. GP: Conceptualization, writing review and editing, supervision.

Corresponding author

Correspondence to Eyal Sheiner.

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Conflict of interest

The authors report no conflict of interest.

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The study was performed following the ethical standards of the 1964 declaration of Helsinki and its later amendments and approved by the Institutional Review Board Committee of SUMC (IRB number SOR-18-0383).

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Roitman, M.S., Wainstock, T., Sheiner, E. et al. Ectopic pregnancy: perinatal outcomes of future gestations and long-term neurological morbidity of the offspring. Arch Gynecol Obstet (2021). https://doi.org/10.1007/s00404-021-05991-2

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Keywords

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