Association between socioeconomic status and ectopic pregnancy rate in the Republic of Korea

Objective To estimate the ectopic pregnancy rate in the Republic of Korea and to identify whether socioeconomic factors contribute to the incidence of ectopic pregnancy. Methods Korean National Health Insurance data from January to December 2009 were analyzed to calculate the rate of ectopic pregnancy. Results Among the patient sample (n = 599 186), 59 261 had diagnosis codes for ectopic pregnancies, abortions, or deliveries, and 1102 ectopic pregnancies were identified. The frequency of ectopic pregnancy treated by either surgery or methotrexate was 16.60 per 1000 pregnancies. Low socioeconomic status was a risk factor for ectopic pregnancy (odds ratio [OR], 1.718; 95% confidence interval [CI], 1.065-2.772; P = 0.03), as was older age (OR, 1.016; 95% CI, 0.998-1.033, P = 0.07), although the association was not significant. Among women aged 25-44 years, low socioeconomic status and age were associated with a high incidence of ectopic pregnancy (OR, 1.863; 95% CI, 1.074-3.233, P = 0.03; and OR, 1.061; 95% CI, 1.041-1.081, P < 0.01, respectively). Surgical and methotrexate treatment rates were 90.7% and 9.3%, respectively. The methotrexate failure rate was 30.7%. The recorded ectopic pregnancy sites were tubal or ovarian (90.2%), cornual (6.0%), cervical (2.8%), and abdominal (1.0%). Conclusion Older age and low socioeconomic status were risk factors for ectopic pregnancy.