Women’s Health
Spontaneous abortion and ectopic pregnancy in the United States: A targeted literature review Colin Kunzweiler* Colin Kunzweiler Sandeep Basnet John Diaz-Decaro
Background: Spontaneous abortion and ectopic pregnancy are associated with myriad physical and psychological sequelae for expectant mothers and families; however, evidence describing their occurrence is limited and disparate. This study identified the rate of spontaneous abortion and ectopic pregnancy in the US.
Methods: We conducted a targeted literature review of MEDLINE and reports from obstetric/gynecologic societies. Authors reviewed titles/abstracts and full texts to determine eligibility. English-language publications of population-based or secondary data sources, surveillance efforts, or systematic reviews and/or meta-analyses, from year 2000 to September 2023 were included.
Results: 103 results from the US were identified in MEDLINE; 12 publications were included. 3 reports from the American College of Obstetricians and Gynecologists (ACOG) were included. Our review identified several definitions regarding gestational age for outcomes. Overall, spontaneous abortion/miscarriage occurs in 11%-39% of recognized pregnancies. The rate of spontaneous abortion/miscarriage is greater in women >30 years of age, and women who identify as race/ethnic minorities. In a report from ACOG, the prevalence of early pregnancy loss before 13 weeks gestation is ~10% among recognized pregnancies. Overall, ectopic pregnancy occurs in ~0.4%-2.4% of recognized pregnancies. The rate of ectopic pregnancy is greater in older women, in women who identify as race/ethnic minorities, and among Medicaid beneficiaries.
Conclusions: Among recognized pregnancies, spontaneous abortion/miscarriage is a common experience among expectant mothers and their families, while the rate of ectopic pregnancy is ~2%. Evidence is limited and professional societies cite rates from studies conducted before year 2000. Future research estimating current population-level burden of spontaneous abortion and ectopic pregnancy and examining individual and structural promotors of these outcomes is needed.