Hospital admissions for ectopic pregnancies in England have seen a substantial increase, with new research indicating that women conceiving at older ages may be a significant factor behind this trend. Analysis of hospital data between 2004 and 2012 showed an average annual rise of approximately 3%, followed by a period of stabilisation until 2021, after which admissions have climbed sharply again, exceeding 4% annually.
Factors Influencing Ectopic Pregnancy Rates
Experts from the University of Liverpool, whose findings were published in The Lancet Regional Health – Europe journal, have identified several potential influences on the upward trend in ectopic pregnancy cases. Beyond the increasing maternal age at conception, the study suggests that changes in hospital management protocols for ectopic pregnancies and the impact of infections may also play a role.
Disparities in Ectopic Pregnancy Admissions
A stark disparity has been highlighted by the research: women living in England's most deprived areas consistently experience higher rates of hospital admission for ectopic pregnancies when compared to those residing in more affluent regions. This difference is further underscored by the fact that between 2013 and 2024, women from the most deprived areas had more than double the hospital admissions for both miscarriage and ectopic pregnancy compared to those in the least deprived areas.
The study further indicates that the majority of these admissions, accounting for 45–55% annually between 2013 and 2024, occurred among women aged 25 to 34. Admissions among women aged 35 to 39 contributed an additional 20–25%, while those aged 20–24 remained relatively stable at around 15–18% each year.
Admissions among women aged 40 and over increased from approximately 7% in 2013 to 12% in 2024, a rise consistent with the national trend of delayed childbearing. This shift is considered a potential contributor to the recent increase in the incidence of ectopic pregnancy. An ectopic pregnancy occurs when a fertilised egg implants outside the uterus, typically in a fallopian tube, and usually requires termination through medication or surgery. It is one of the most common early pregnancy complications, with an estimated 11,000 hospital admissions annually in England, or roughly one in every 90 pregnancies.
Broader Trends in Pregnancy Complications
In parallel, the research examined hospital admissions for miscarriage, which saw a significant decline between 2018 and 2021, followed by a suggestion of a modest rise after 2021. Several factors may have influenced these changes, including Covid-19 infections and altered care during the pandemic, alongside the progressive increase in maternal age at conception, a rising prevalence of obesity, and broader environmental and lifestyle changes, all independently associated with increased miscarriage risk.
The researchers concluded that the higher admission rates for both miscarriage and ectopic pregnancy in the most deprived areas reflect contributing factors such as higher rates of smoking (19% versus 6%) and obesity (36% versus 22%), alongside reduced access to early maternity care.
