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RÉSUMÉ
Introduction. La grossesse extra-utérine (GEU) est un problème majeur de santé publique à l’échelle planétaire de par sa fréquence et sa gravité. Elle constitue la première cause de mortalité maternelle au premier trimestre de la grossesse surtout dans les pays en développement. L’objectif de ce travail était d’identifier ses facteurs de risque. Matériels et méthodes. Nous avons réalisé une étude cas-témoins non apparié à l’Hôpital de référence de Talangaï à Brazzaville de 2018 à 2019. Les données ont été traitées et analysées avec le logiciel STATA 15. L’analyse bivariée a permis de tester les associations entre les variables d’étude au seuil de 5%. Une analyse des correspondances multiples a vérifié les proximités entre plusieurs facteurs de risque. La régression logistique a été utilisée pour identifier les facteurs de risque de la GEU. Résultats. La fréquence de la GEU était de 0,98%. Notre étude a ressorti plusieurs de ses facteurs de risque, dont : les antécédents de MIP (AOR=13,2 ; IC95% = [6,4-27,3]), d’avortement provoqué (AOR=6,4 ; IC95% = [2,9-13,7]), d’avortement spontané (AOR=2,8 ; IC95% = [1,2-6,9]), de GEU antérieure (AOR=16,3 ; IC95%= [2,2-122,7]) et de kystectomie (AOR=17,6 ; IC95% = [7,8-39,2]), le statut célibataire (AOR=7,7 ; IC95%= [2,5-24,3]), la nulliparité (AOR=34,6 ; IC95% = [7,7-156,2]), la primiparité (AOR=4,4 ; IC95%= [1,2-16,2]). Conclusion. La GEU est une urgence pouvant engager le pronostic vital des femmes. L’identification de ses facteurs de risque permet de mettre en œuvre des interventions de prévention efficaces.


ABSTRACT
Introduction. Ectopic pregnancy (EP) is a major public health problem worldwide due to its frequency and severity. It is the first cause of maternal mortality in the first trimester of pregnancy, especially in developing countries. The objective of this work is to identify its risk factors. Methodology. We conducted an unpaired case-control study at the HRT of Brazzaville from 2018 to 2019. Data were processed and analyzed with STATA 15 software. Bivariate analysis tested associations between study variables at the 5% threshold. Multiple correspondence analysis tested for proximities between multiple risk factors. Logistic regression was used to identify risk factors for EP. Results. The frequency of EP was 0.98%. Our study identified several of its risk factors, including: history of PID (AOR=13.2; CI95%=[6.4-27.3]), induced abortion (AOR=6.4; CI95%=[2.9-13.7]), spontaneous abortion (AOR=2.8; CI95%=[1.2-6.9]), previous EP (AOR=16.3; CI95%=[2.2-122.7]) and cystectomy (AOR=17.6; CI95%=[7.8-39.2]), single status (AOR=7.7; CI95%=[2.5-24.3]), nulliparity (AOR=34.6; CI95%=[7.7-156.2]), primiparity (AOR=4.4; CI95%=[1.2-16.2]). Conclusion. EP is a life-threatening emergency for women. The identification of its risk factors allows the implementation of effective prevention interventions.

Keywords

EP , risk factors case-control HRT Brazzaville GEU facteurs de risque, cas-témoins HRT Brazzaville

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Melania Angue, E. O., Y, A., AC, N., D, M. E., Y, V., H, N., H, I., G, D., & Pierre Marie, T. (2022). Facteurs de Risque de la Grossesse Extra-Utérine à l’Hôpital de Référence de Talangaï (Brazzaville) de 2018 à 2019: Facteurs de Risque de la Grossesse Extra-Utérine à Talangaï, Brazzaville. HEALTH SCIENCES AND DISEASE, 23(5). https://doi.org/10.5281/hsd.v23i5.3629
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References

  1. Mpiima DP, Wasswa Salongo G, Lugobe H, Ssemujju A, Mumbere Mulisya O, Masinda A, et al. Association between Prior Chlamydia trachomatis Infection and Ectopic Pregnancy at a Tertiary Care Hospital in South Western Uganda. Obstet Gynecol Int [Internet]. 1 de marzo de 2018 [citado 14 de enero de 2021];2018. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852882/
  2. Diarra L, Samaké A, Konaté M, Keita M, Diallo M, Traore SO, et al. Grossesse Extra-Utérine Rompue de Diagnostic Tardif. Health Sci Dis [Internet]. 21 de marzo de 2020 [citado 14 de agosto de 2020];21(4). Disponible en: https://www.hsd-fmsb.org/index.php/hsd/article/view/1948
  3. Mikhail E, Salemi JL, Schickler R, Salihu HM, Plosker S, Imudia AN. National rates, trends and determinants of inpatient surgical management of tubal ectopic pregnancy in the United States, 1998–2011. J Obstet Gynaecol Res. 2018;44(4):730-8.
  4. Kahn-Jochimek A. Le programme de développement durable [Internet]. Développement durable. [citado 1 de septiembre de 2020]. Disponible en: https://www.un.org/sustainabledevelopment/fr/development-agenda/
  5. Li C, Zhao W-H, Zhu Q, Cao S-J, Ping H, Xi X, et al. Risk factors for ectopic pregnancy: a multi-center case-control study. BMC Pregnancy Childbirth. 22 de agosto de 2015;15:187.
  6. Lawani OL, Anozie OB, Ezeonu PO. Ectopic pregnancy: a life-threatening gynecological emergency. Int J Womens Health. 19 de agosto de 2013;5:515-21.
  7. Marion LL, Meeks GR. Ectopic Pregnancy: History, Incidence, Epidemiology, and Risk Factors. Clin Obstet Gynecol. junio de 2012;55(2):376-86.
  8. Stulberg DB, Zhang JX, Lindau ST. Socioeconomic Disparities in Ectopic Pregnancy: Predictors of Adverse Outcomes from Illinois Hospital-Based Care, 2000–2006. Matern Child Health J. febrero de 2011;15(2):234.
  9. Filho EAR, Santana DS, Cecatti JG, Costa ML, Haddad SM, Parpinelli MA, et al. Awareness about a Life-Threatening Condition: Ectopic Pregnancy in a Network for Surveillance of Severe Maternal Morbidity in Brazil. BioMed Res Int [Internet]. 2014 [citado 25 de agosto de 2020];2014. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3977561/
  10. Kamga DVT, Nana PN, Fouelifack FY, Fouedjio JH. Contribution des avortements et des grossesses extra-utérines dans la mortalité maternelle dans trois hôpitaux universitaires de Yaoundé. Pan Afr Med J [Internet]. 3 de agosto de 2017 [citado 25 de febrero de 2021];27. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622819/
  11. Mortalité maternelle [Internet]. [citado 14 de agosto de 2020]. Disponible en: https://www.who.int/fr/news-room/fact-sheets/detail/maternal-mortality
  12. Abou Zahr C, Wardlaw TM, World Health Organization, United Nations Population Fund, UNICEF, editores. Maternal mortality in 2000: estimates developed by WHO, UNICEF, and UNFPA. Geneva: Dept. of Reproductive Health and Research, World Health Organization; 2004. 30 p.
  13. Sultana S, Asif HM, Akhtar N. Incidence rate and prevalence of major risk factors for ectopic pregnancy in the Pakistani population: mini-review. Asian Pac J Trop Dis. 1 de marzo de 2015;5(3):246-50.
  14. Filippi V, Chou D, Ronsmans C, Graham W, Say L. Levels and Causes of Maternal Mortality and Morbidity. En: Black RE, Laxminarayan R, Temmerman M, Walker N, editores. Reproductive, Maternal, Newborn, and Child Health: Disease Control Priorities, Third Edition (Volume 2) [Internet]. Washington (DC): The International Bank for Reconstruction and Development / The World Bank; 2016 [citado 10 de agosto de 2020]. Disponible en: http://www.ncbi.nlm.nih.gov/books/NBK361917/
  15. Nzaumvila DK, Govender I, Ogunbanjo GA. An audit of the management of ectopic pregnancies in a district hospital, Gauteng, South Africa. Afr J Prim Health Care Fam Med. 30 de octubre de 2018;10(1):8.
  16. Lisonkova S, Tan J, Wen Q, Abdellatif L, Richter LL, Alfaraj S, et al. Temporal trends in severe morbidity and mortality associated with ectopic pregnancy requiring hospitalisation in Washington State, USA: a population-based study. BMJ Open. 1 de febrero de 2019;9(2):e024353.
  17. Uzabakiriho B, Maswime S. Causes of maternal death at Natalspruit Hospital, Johannesburg, South Africa. S Afr Med J. 31 de mayo de 2019;109(6):412-414-414.
  18. Assouni Mindjah YA, Essiben F, Foumane P, Dohbit JS, Mboudou ET. Risk factors for ectopic pregnancy in a population of Cameroonian women: A case-control study. Mitchell C, editor. PLOS ONE. 12 de diciembre de 2018;13(12):e0207699.
  19. Picaud A, Nlome-Nze A, Faye A, Kouvahe V, Kpodar D, Ouzouaki F, et al. Evolution de la frequence de la grossesse extra-utérine. Médecine afrique noire. 1992;39(12).
  20. Madoue B, Saleh A, Wilfried ISR, Kolomso D. Grossesse extra-utérine : Aspects épidémiologiques et Pronostic maternel à l’Hôpital de district de N’djamena sud (Tchad). 2015;6(1):6.
  21. Sépou A, Yanza M-C, Goddot M, Ngbalé R, Kouabosso A, Penguélé A, et al. À propos de 116 cas de grossesses extra-utérines observées à Bangui (Centrafrique)*. Cah Détudes Rech Francoph Santé. 1 de enero de 2003;13(1):29-30.
  22. 22. Iloki LH, Itoua C, Ibara JR, Koubaka R. Note sur les grossesses extra-utérines au CHU de Brazzaville au Congo. Médecine Afr Noire. du Mai de 2000;numéro 0500:1.
  23. Patiely N. Memoire Online - Expression de MUC 1 dans les grossesses extra- utérines [Internet]. Memoire Online. [citado 1 de abril de 2020]. Disponible en: https://www.memoireonline.com/10/12/6224/m_Expression-de-MUC-1-dans-les-grossesses-extra-uterines6.html
  24. Moran NF. Preventing maternal deaths due to ectopic pregnancy. S Afr Med J. 26 de noviembre de 2018;108(12):1018-1020-1020.
  25. Taran F-A, Kagan K-O, Hübner M, Hoopmann M, Wallwiener D, Brucker S. The Diagnosis and Treatment of Ectopic Pregnancy. Dtsch Aerzteblatt Online [Internet]. 9 de octubre de 2015 [citado 8 de mayo de 2020]; Disponible en: https://www.aerzteblatt.de/10.3238/arztebl.2015.0693
  26. Abdulkareem TA, Eidan SM. Ectopic Pregnancy: Diagnosis, Prevention and Management. Obstetrics [Internet]. 20 de diciembre de 2017 [citado 7 de mayo de 2020]; Disponible en: https://www.intechopen.com/books/obstetrics/ectopic-pregnancy-diagnosis-prevention-and-management
  27. Guillaume A, Rossier C. L’avortement dans le monde. État des lieux des législations, mesures, tendances et conséquences. Population. 18 de octubre de 2018; Vol. 73(2):225-322.
  28. HCSP. Santé sexuelle et reproductive [Internet]. Rapport de l’HCSP. Paris: Haut Conseil de la Santé Publique; 2016 mar [citado 2 de abril de 2020]. Disponible en: https://www.hcsp.fr/explore.cgi/avisrapportsdomaine?clefr=550
  29. Dp M. Factors Associated with Ectopic Pregnancy at Mbarara University Teaching Hospital in South Western Uganda. :6.
  30. Brüggmann D, Kollascheck J, Quarcoo D, Bendels MH, Klingelhöfer D, Louwen F, et al. Ectopic pregnancy: exploration of its global research architecture using density-equalising mapping and socioeconomic benchmarks. BMJ Open [Internet]. 11 de octubre de 2017 [citado 5 de mayo de 2020];7(10). Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652463/
  31. Tolefac PN, Abanda MH, Minkande JZ, Priso EB. The challenge in the diagnosis and management of an advanced abdominal pregnancy in a resource-low setting: a case report. J Med Case Reports [Internet]. 2017 [citado 5 de mayo de 2020];11. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523149/
  32. Baffoe P, Fofie C, Gandau BN. Term Abdominal Pregnancy with Healthy Newborn: A Case Report. Ghana Med J. junio de 2011; 45(2):81-3.
  33. Tulandi T, editor. Ectopic Pregnancy: A Clinical Casebook [Internet]. Cham: Springer International Publishing; 2015 [citado 28 de febrero de 2021]. Disponible en: http://link.springer.com/10.1007/978-3-319-11140-7
  34. Tebeu P-M, Belinga E, Sama JD, Kenmogne SA, Tchente C, Sandjong I. Aspects épidémiologiques, cliniques et thérapeutiques des algies pelviennes aiguës de la femme à l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé (HGOPY). Pan Afr Med J [Internet]. 23 de enero de 2020 [citado 1 de septiembre de 2020];35. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170743/
  35. Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update. 1 de marzo de 2014;20(2):250-61.
  36. Sivalingam VN, Duncan WC, Kirk E, Shephard LA, Horne AW. Diagnosis and management of ectopic pregnancy. J Fam Plan Reprod Health Care Fac Fam Plan Reprod Health Care R Coll Obstet Gynaecol. octubre de 2011;37(4):231-40.
  37. Lee R, Dupuis C, Chen B, Smith A, Kim YH. Diagnosing ectopic pregnancy in the emergency setting. Ultrasonography. enero de 2018;37(1):78-87.
  38. Barash JH, Buchanan EM, Hillson C. Diagnosis and Management of Ectopic Pregnancy. Am Fam Physician. 1 de julio de 2014; 90(1):34-40.
  39. Anis F, G M, Ns N, Reddy AS. A prospective study of morbidity patterns in ectopic pregnancy at a tertiary care hospital. Obs Gyne Rev J Obstet Gynecol. 2016;2(3):35-8.
  40. Chouinard M. Portrait des grossesses ectopiques au Québec et leurs retombées sur la santé reproductive. 10 de mayo de 2019 [citado 2 de abril de 2020]; Disponible en: https://papyrus.bib.umontreal.ca/xmlui/handle/1866/22872
  41. these199-17.pdf [Internet]. [citado 18 de octubre de 2020]. Disponible en: http://wd.fmpm.uca.ma/biblio/theses/annee-htm/FT/2017/these199-17.pdf
  42. Complications liées à l’exposition in utero au diéthylstilbestrol (DES)(Distilbène®, Stilboestrol-Borne®). 2011;9.
  43. Fouedjio JH, Fouelifack YF, Fouogue TJ, Kana LM, Mbu ER. Clinical features of extra-uterine pregnancy in Cameroon: a review of 148 cases at the Yaounde Central Hospital. :5.
  44. Fernández Arenas C. El embarazo ectópico se incrementa en el mundo. Rev Cuba Obstet Ginecol. marzo de 2011;37(1):84-99.
  45. Memoire Online - Appartenance socioculturelle et scolarisation des enfants au Burkina Faso - Lonkila Moussa ZAN [Internet]. Memoire Online. [citado 18 de julio de 2019]. Disponible en: https://www.memoireonline.com/08/09/2647/m_Appartenance-socioculturelle-et-scolarisation-des-enfants-au-Burkina-Faso4.html
  46. Parashi S, Moukhah S, Ashrafi M. Main Risk Factors for Ectopic Pregnancy: A Case-Control Study in A Sample of Iranian Women. Int J Fertil Steril. 2014; 8(2):147-54.
  47. Jacob L, Kalder M, Kostev K. Risk factors for ectopic pregnancy in Germany: a retrospective study of 100,197 patients. GMS Ger Med Sci [Internet]. 19 de diciembre de 2017 [citado 13 de enero de 2021];15. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5738501/
  48. Gerema U, Alemayehu T, Chane G, Desta D, Diriba A. Determinants of ectopic pregnancy among pregnant women attending referral hospitals in southwestern part of Oromia regional state, Southwest Ethiopia: a multi-center case control study. BMC Pregnancy Childbirth. diciembre de 2021;21(1):130.
  49. Njingu AE, Cumber SN, Geh MM, Edgar MML, Nkfusai CN, Ngunde JP, et al. Incidence, risk factors, clinical presentation and treatment of ectopic pregnancy in the Limbe and Buea Regional Hospitals in Cameroon. PAMJ Clin Med [Internet]. 2020 [citado 12 de enero de 2021];2. Disponible en: https://www.clinical-medicine.panafrican-med-journal.com/content/article/2/95/full/
  50. Asah‐Opoku K, Oppong SA, Ameme DK, Nuamah MA, Mumuni K, Yeboah AO, et al. Risk factors for ectopic pregnancy among pregnant women attending a tertiary healthcare facility in Accra, Ghana. Int J Gynecol Obstet. octubre de 2019; 147(1):120-5.
  51. Ragab A, Mesbah Y, El-Bahlol I, Fawzy M, Alsammani MA. Predictors of ectopic pregnancy in nulliparous women: A case-control study. Middle East Fertil Soc J. 1 de marzo de 2016; 21(1):27-30.
  52. Gerema U, Alemayehu T, Chane G, Desta D, Diriba A. Determinants of ectopic pregnancy among pregnant women attending referral hospitals in Southwestern parts of Oromia regional state, Southwest Ethiopia: A multi-center case control study [Internet]. In Review; 2020 ene [citado 12 de enero de 2021]. Disponible en: https://www.researchsquare.com/article/rs-12139/v1
  53. Aj B, H D. Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital. Crit Care Obstet Gynecol [Internet]. 14 de febrero de 2017 [citado 29 de enero de 2021];3(1). Disponible en: https://obstetrics.imedpub.com/abstract/frequency-of-tubal-ectopic-pregnancy-and-mode-of-management-at-althawra-general-modern-hospital-18335.html
  54. Sanogo DB. Grossesse extra utérine : Aspects épidémiologiques et Anatomopathologiques de la grossesse extra-utérine au centre de santé de référence de la commune VI du district de Bamako. 2012 [citado 29 de enero de 2021]; Disponible en: https://library.adhl.africa/handle/123456789/10074
  55. Shobeiri F, Tehranian N, Nazari M. Trend of ectopic pregnancy and its main determinants in Hamadan province, Iran (2000-2010). 2014;5.
  56. Ha A-T. Ectopic pregnancy. Prevalence and risk factors in women attending a tertiary care hospital in Saudi Arabia. Saudi Med J. 1 de agosto de 2012;33(8):875-8.
  57. Baldé IS, Diallo FB, Conté I, Diallo MH, Sylla I, Diallo BS, et al. Ectopic pregnancy at the Ignace Deen University Hospital in Conakry: Epidemiologic, social, demographic, therapeutic, and prognostic aspects. Médecine Santé Trop. julio de 2014;24(3):297-300.
  58. Zhang D, Shi W, Li C, Yuan J-J, Xia W, Xue R-H, et al. Risk factors for recurrent ectopic pregnancy: a case–control study. BJOG Int J Obstet Gynaecol. 2016;123(S3):82-9.
  59. Barnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. julio de 2006;86(1):36-43.