Because of inconsistent findings among case-control studies on the relationship between IUD use and the risk of ectopic pregnancy, a meta-analysis of published literature was conducted. From 1977 through 1994, 19 publications regarding 16 studies of ectopic pregnancy and IUD use were found by MEDLINE and manual search. The odds ratio (ORs) of ectopic pregnancy with current and past IUD use in each study were pooled. A quality score system was developed to assess each study. Funnel plot was used to assess potential publication biases. For current IUD use, when cases were compared to pregnant controls, there was an increased risk of ectopic pregnancy (pooled OR: 10.63, 95% confidence interval (CI): 7.66-14.74); when cases were compared to non-pregnant controls, there was no risk of ectopic pregnancy (pooled OR: 1.06, 95% CI: 0.91-1.24). Past IUD use could mildly increase the risk of ectopic pregnancy (pooled OR: 1.40, 95% CI: 1.23-1.59). Selecting pregnant or non-pregnant women as controls, however, did not affect the OR estimates of past IUD use. Current IUD use does not increase the risk of the ectopic pregnancy. However, a pregnancy with an IUD in situ is more often an ectopic one than a pregnancy with no IUD. Past IUD use could mildly elevate the risk of ectopic pregnancy.

译文

:由于病例对照研究中宫内节育器使用与异位妊娠风险之间关系的研究结果不一致,因此对已发表文献进行了荟萃分析。从1977年到1994年,通过MEDLINE和手动搜索发现了19篇关于16例异位妊娠和宫内节育器使用研究的出版物。汇总了每项研究中异位妊娠与当前和过去使用宫内节育器的比值比(OR)。开发了质量评分系统来评估每项研究。漏斗图用于评估潜在的出版偏倚。对于目前使用的宫内节育器,将病例与怀孕的对照组进行比较,异位妊娠的风险增加(合并OR:10.63,95%置信区间(CI):7.66-14.74);当将病例与非妊娠对照进行比较时,没有异位妊娠的风险(合并OR:1.06,95%CI:0.91-1.24)。过去使用宫内节育器可能会轻度增加异位妊娠的风险(合并OR:1.40,95%CI:1.23-1.59)。然而,选择孕妇或非孕妇作为对照并不会影响过去宫内节育器使用的OR估计值。当前使用宫内节育器不会增加异位妊娠的风险。但是,原位宫内节育器的妊娠比没有宫内节育器的妊娠更常是异位妊娠。过去使用宫内节育器可能会轻度增加异位妊娠的风险。

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