Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2014 Dec 10;9(12):e115031.
doi: 10.1371/journal.pone.0115031. eCollection 2014.

Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study

Cheng Li  1 , Wei-Hong Zhao  1 , Chun-Xia Meng  2 , Hua Ping  3 , Guo-Juan Qin  4 , Shu-Jun Cao  5 , Xiaowei Xi  6 , Qian Zhu  1 , Xiao-Cui Li  1 , Jian Zhang  1
Affiliations
Multicenter Study

Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study

Cheng Li et al. PLoS One. .

Abstract

Objective: To evaluate the association between the risk of ectopic pregnancy (EP) and the use of common contraceptives during the previous and current conception/menstrual cycle.

Methods: A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411). Women with intrauterine pregnancy (IUP) (n = 2,416) and non-pregnant women (n = 2,419) were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and the corresponding 95% confidential intervals (CIs).

Results: Previous use of intrauterine devices (IUDs) was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27]), and the risk increased with the duration of previous use (P1 for trend <10-4, P2 for trend <10-4). The current use of most contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022]) and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]). However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07]), LNG-EC (AOR2 = 4.87 [3.88-6.10]), IUDs (AOR2 = 21.08 [13.44-33.07]), and tubal sterilization (AOR2 = 7.68 [1.69-34.80]) increased the risk of EP compared with the non-use of contraceptives.

Conclusion: Current use of most contraceptives reduce the risk of both IUP and EP. However, if the contraceptive method fails, the proportions of EP may be higher than those of non-users. In the case of contraceptive failure in the current cycle, EP cases should be differentiated according to current use of OCPs, LNG-EC, IUDs, and tubal sterilization. In addition, attention should be paid to women with previous long-term use of IUDs.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The definition of previous cycle and current cycle.
Figure 2
Figure 2. The recruitment profile for this study.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Farquhar CM (2005) Ectopic pregnancy. Lancet 366:583–591. - PubMed
    1. Walker JJ (2007) Ectopic pregnancy. Clin Obstet Gynecol 50:89–99. - PubMed
    1. Rana P, Kazmi I, Singh R, Afzal M, Al-Abbasi FA, et al. (2013) Ectopic pregnancy: a review. Arch Gynecol Obstet 288:747–757. - PubMed
    1. Zheng X, Tan L, Ren Q, Cui Z, Wu J, et al. (2012) Trends in contraceptive patterns and behaviors during a period of fertility transition in China: 1988–2006. Contraception 86:204–213. - PubMed
    1. Mol BW, Ankum WM, Bossuyt PM, Van der Veen F (1995) Contraception and the risk of ectopic pregnancy: a meta-analysis. Contraception 52:337–341. - PubMed

Publication types

Substances

Grants and funding

This work was supported by Shanghai Scientific and Technical Committee Grants (124119a4802). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.