title: Ectopic pregnancy is again on the increase. Recent trends in the incidence of ectopic pregnancies in France (1992-2002).
abstract: BACKGROUND
  We aimed to assess the recent incidence trends of ectopic pregnancies (EP) in France (1992-2002).
  
  
  METHODS
  A population-based register of all women aged 15-44 years with EP was set up in Auvergne (central France). We calculated rates of EP as a 'reproductive failure' or as a 'contraceptive failure', frequencies of exposure to the two main risk factors for EP (cigarette smoking and chlamydial infection) and contraceptive methods between 1992 and 2002.
  
  
  RESULTS
  The overall EP rate decreased by 2%, from 96.4 per 100 000 women aged 15-44 in 1992 to 95.3 per 100 000 in 2002. However, the rate of 'reproductive failure' EP increased by 17%, while the rate of 'contraceptive failure' EP, mostly intrauterine device failure, decreased by 29%.
  
  
  CONCLUSIONS
  Appropriate analysis reveals that the rate of EP as reproductive failure is increasing again in France. This result is of interest for many European and North America countries where chlamydial infections or smoking or both are increasing in women of reproductive age. The rates of EP as contraceptive failure and of that as reproductive failure evolve differently in the population and should not be confused in epidemiological studies.
authors.affiliation: INSERM U569-IFR 69, Hôpital de Bicêtre, 94276 Le Kremlin-Bicêtre, France. coste@cochin.univ-paris5.fr
authors.forename: Joël
authors.initials: J
authors.lastname: Coste
authors.forename: Jean
authors.initials: J
authors.lastname: Bouyer
authors.forename: Sylvie
authors.initials: S
authors.lastname: Ughetto
authors.forename: Laurent
authors.initials: L
authors.lastname: Gerbaud
authors.forename: Hervé
authors.initials: H
authors.lastname: Fernandez
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Pouly
authors.forename: Nadine
authors.initials: N
authors.lastname: Job-Spira
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000150:complications; D003267:Contraception / Q000009:adverse effects; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007434:Intrauterine Devices / Q000009:adverse effects; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D012907:Smoking / Q000009:adverse effects