Population-based study on the effect of socioeconomic factors and race on management and outcomes of 35,535 inpatient ectopic pregnancies.

STUDY

OBJECTIVE

To evaluate whether socioeconomic variables influence the management and outcomes of ectopic pregnancies.

DESIGN

Retrospective cohort study (Canadian Task Force classification II-2).

SETTING

Hospitals in the United States participating in the Health Care Cost and Utilization Project.

PATIENTS: Women (n = 35 535) with a primary discharge diagnosis of ectopic pregnancy.

INTERVENTIONS: Effect of socioeconomic factors and race/ethnicity on management and adverse outcomes of ectopic pregnancy.

MEASUREMENTS AND MAIN

RESULTS

During the 9-year study, 35 535 ectopic pregnancies were identified. The development of hemoperitoneum in 8706 patients (24.50%) was the most common complication. Asian race was the sociodemographic variable most predictive of hemoperitoneum (odds ratio [OR], 1.41; 95% confidence interval [CI], 1.24-1.61; p < .01) and transfusion (OR, 1.62; 95% CI, 1.39-1.89; p < .01), and Medicare status was most influential on prolonged hospitalization (OR, 1.83; 95% CI, 1.36-2.47; p < .01). Major complications were not affected by socioeconomic factors. Laparotomy in 25 075 patients (70.6%) was the most common treatment option. Patients of Asian or Pacific Islander descent were least likely to be treated non-surgically (OR, 0.62; 95% CI, 0.51-0.76; p < .01), whereas Medicare recipients were most likely to be treated non-surgically (OR, 1.70; 95% CI, 1.32-2.18; p < .01). All non-white groups were less likely to undergo a laparoscopic approach.

CONCLUSION

Major complications from ectopic pregnancy are not influenced by socioeconomic variables; however, less serious complications and management approaches are persistently affected.