Clinical Characteristics and Associated Factors of Recurrent Versus Primary Ectopic Pregnancy: A Cross-sectional Study

AuthorHadis Exiren
AuthorMaryam Razavien
AuthorMahjob Sargazi Taghazien
OrcidMaryam Razavi [0000-0001-9983-9743]en
Issued Date2026-06-30en
AbstractBackground: Recurrent ectopic pregnancy (REP) poses substantial clinical risks, including maternal morbidity and reduced fertility potential. Identifying factors that differentiate recurrent ectopic pregnancy from primary ectopic pregnancy (EP) is essential for improving early diagnosis and management. Objectives: This study aimed to characterize and compare the clinical and laboratory features of recurrent versus primary EP at a referral center in southeastern Iran. Methods: This cross-sectional study included 78 women diagnosed with EP between 2017 and 2021 at Ali Ibn Abi Talib Hospital. Participants were classified as having primary EP (n = 39) or recurrent EP (n = 39). Data were extracted from medical records and structured interviews. Analyses included t-tests, chi-square tests, and Mann-Whitney U tests, as appropriate. Effect sizes (Cohen d) and crude odds ratios with 95% confidence intervals were calculated for exploratory bivariate comparisons. Results: In unadjusted comparisons, women with recurrent EP were significantly older than those with primary EP (31.6 ± 6.0 vs 27.3 ± 5.1 years; d = 0.77) and had lower parity (0.9 ± 0.7 vs 1.6 ± 0.8; d = -0.93). Recurrent cases had higher rates of low educational attainment (53.8% vs 30.8%; OR = 2.62), smoking (35.9% vs 15.4%; OR = 3.08), infertility (41.0% vs 17.9%; OR = 3.18), previous cesarean section (33.3% vs 12.8%; OR = 3.40), and intrauterine device use (46.2% vs 20.5%; OR = 3.32). Recurrent EP also presented at an earlier gestational age (6.1 ± 1.4 vs 7.4 ± 1.6 weeks; d = -0.86) and with lower β-hCG levels (1740 ± 960 vs 2650 ± 1180 mIU/mL; d = -0.85). Clinically, abdominal pain (84.6% vs 64.1%; OR = 3.08) and syncope (28.2% vs 10.3%; OR = 3.44) were more common in the recurrent EP group. Conclusions: Recurrent EP appears to constitute a distinct clinical subgroup, with higher frequencies of infertility, smoking, prior cesarean section, and intrauterine device use, as well as earlier presentation and lower β-hCG values, than primary EP. However, because the analyses were bivariate and the sample size was modest, these findings should be interpreted as exploratory rather than as independent predictors. Larger prospective studies with adequate power for multivariable modeling are needed to confirm these associations and support the development of predictive models for recurrence.en
DOIhttps://doi.org/10.5812/jnms-167337en
URIhttps://brieflands.com/journals/jnms/articles/167337en
KeywordEctopic Pregnancyen
KeywordRecurrent Ectopic Pregnancyen
KeywordRisk Factorsen
PublisherBrieflandsen
TitleClinical Characteristics and Associated Factors of Recurrent Versus Primary Ectopic Pregnancy: A Cross-sectional Studyen
TypeResearch Articleen

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