The environmental risk factors associated with ectopic pregnancy: An umbrella review - 25/01/23
Abstract |
Introduction |
Ectopic pregnancy(EP) is the implantation of a fertilized ovum outside of the uterine cavity. The incidence of EP has steadily increased around the world. The present umbrella review evaluated risk factors prior to conception associated with EP based on meta-analyses and systematic reviews.
Methods |
We searched PubMed, Scopus, and Web of Science until June 25, 2021. All meta-analyses that had focused on assessing the risk factors associated with EP were included. We calculated summary effect estimates, 95% CI, heterogeneity I², 95% prediction interval, small-study effects, excess significance biases, and sensitive analysis. The quality of the meta-analyses was evaluated with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2).
Results |
Two risk factors including chlamydia trachomatis (OR: 3.03) and smoking (OR: 1·77) were graded as suggestive evidence (class III). IUD with pregnant control (OR: 10.63) and endometriosis for case-control studies (OR: 2·66) and tubal ligation with pregnant control (OR: 9.3) were graded as risk factors with weak evidence (class IV). Tubal ligation with non-pregnant control was a protective factor (class IV). IUD with non-pregnant control and endometriosis for cohort studies were not as risk factors for EP.
Conclusion |
Two risk factors involving smoking and chlamydia trachomatis and three risk factors involving IUD use, endometriosis, and tubal ligation were classified as suggestive evidence and weak evidence for EP, respectively. Strong evidence for risk factors of EP was not achieved, indicating the degree of uncertainty and bias, which bring an emergency to conduct further no-bias studies.
Systematic review registration |
PROSPERO (CRD42021281632)
Le texte complet de cet article est disponible en PDF.Keywords : Ectopic pregnancy, Chlamydia trachomatis, Risk factor, Umbrella review, Meta-analyses
Abbreviations : EP, AMSTAR 2, PID, OCPs, IUDs, ART, PRISMA, OR
Plan
Vol 52 - N° 2
Article 102532- février 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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