Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments, 2006–2013
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Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments, 2006–2013

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    • Alternative Title:
      Matern Child Health J
    • Description:
      Objectives Ectopic pregnancy is an important adverse pregnancy outcome that is under-surveilled. Emergency department (ED) data can help provide insight on the trends of ectopic pregnancy incidence in the United States (US). Methods Data from the largest US all-payer ED database, the Healthcare Cost and Utilization Project Nationwide ED Sample, were used to identify trends in the annual ratio of ED ectopic pregnancy diagnoses to live births during 2006–2013, and the annual rate of diagnoses among all pregnancies during 2006–2010. Diagnoses were identified through International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis and procedure codes and CPT codes. Results The overall ratio of weighted ED visits with an ectopic pregnancy diagnosis during 2006–2013 was 12.3 per 1,000 live births. This ratio increased significantly from 2006–2013, from 11.0 to 13.7 ectopic pregnancies per 1,000 live births, with no inflections in trend. The rate of ectopic pregnancy diagnoses per 1,000 pregnancies increased during 2006–2010, from 7.0 to 8.3, with no inflections in trend. Females of all age groups experienced increases, though increases were less pronounced with increasing age. All geographic regions experienced increases, with increases being most pronounced in the Northeast. Conclusions Our study suggests that ED ectopic pregnancy diagnoses may be increasing in the US, although the drivers of these increases are not clear. Our results highlight the need for national measures of total pregnancies, stratified by pertinent demographic variables, to evaluate trends in pregnancy-related conditions among key populations.
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