IDENTIFICATION OF KEY RISK FACTORS FOR ECTOPIC PREGNANCY: A CASE-CONTROL STUDY AMONG PAKISTANI WOMEN

Abstract

Objective: To determine and examine the most important risk factors that lead to ectopic pregnancies in Pakistani women in terms of reproductive history, contraceptive use, and surgical history. Place and Duration: The study was performed at Karachi Metropolitan University Abbasi Shaheed Hospital Karachi during March 2025 to March 2026. Methods: In this study, 250 pregnant women were recruited as controls, and 125 women with ectopic pregnancy. Ectopic pregnancy diagnosis was established using detailed menstrual history, physical examination, serial β-human chorionic gonadotropin (βhCG) testing, and abdominal/transvaginal ultrasonography. A questionnaire was used to collect demographic, menstrual, and reproductive information. The statistical analysis was conducted with SPSS version 16, and binary logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: The study found significant associations between ectopic pregnancy and abdominal/pelvic surgery (OR=5.09, 95% CI 1.95-12.81, p<0.001), IUD use (OR=4.54, 95% CI 1.53-13.12, p<0.001), and tubal ligation (OR=4.22, 95% CI 1.09-16.34, p<0.001). Ectopic pregnancy history was highly predictive (OR=60.72, 95% CI 6.45-510.22, p<0.001). Other factors, such as abortion (OR=6.12, 95% CI 3.67-10.39) and age, exhibited weaker relationships with p-values of 0.92 and 0.08, respectively. Conclusion: Women with a prior history of ectopic pregnancy, abdominal/pelvic surgery, IUD, and tubal ligation were at a significant risk of ectopic pregnancy. These observations underscore the importance of pre-conception counseling and early screening programs to alleviate maternal morbidity. More research is necessary to determine the importance of infections and other possible risk factors in ectopic pregnancy.