Ectopic Pregnancies and Spontaneous Abortions in New York City—Incidence and Characteristics

Abstract

All fetal deaths regardless of period of gestation must be reported in the City of New York. From such reports for 1952 to 1954 detailed data are presented on reported ectopic pregnancies and spon-taneous abortions at less than 20 weeks gestation. Reported incidence of ectopic pregnancy is about 3 times as high among nonwhites as among whites; it occurs more frequently as maternal age increases but the rate of increase is greater among Grava I women than among those of higher pregnancy orders; in general, for each age group incidence decreases with advanc-ing numbers of pregnancies; yet ectopic pregnancy occurs more frequently among women who have had earlier fetal loss. Spontaneous early fetal death (i.e. fetal deaths at less than 20 weeks gestation other than ectopic pregnancy or induced abor-tion) also occurs more frequently among nonwhites than whites, ratio to live births among the former being double that among the latter. Age-gravidity patterns in the 2 groups differ, al-though both show a consistent rise with maternal age for first pregnancies. Risk of early abortion rises rapidly with preg-nancy order at ages 15-19 but at ages 45 and over the highest risk is found among first pregnancies and the lowest among Grava V or higher. Risk of spontaneous abortion is found to be more than 10 times as high among women with history of previous fetal loss than among those with no such history. Al-most 75% of spontaneous early fetal loss is of unknown cause, even including cases where "bleeding" or spotting" is the only condition cited by the attending physician. If these cases are excluded, the proportion of unknown or ill-defined cause rises to 96. The implications of the findings are discussed.