国际妇产科学杂志

国际妇产科学杂志 ›› 2025, Vol. 52 ›› Issue (5): 574-580.doi: 10.12280/gjfckx.20250652

• 产科生理及产科疾病: 论著 • 上一篇    下一篇

1990—2021年中国异位妊娠疾病负担的年龄-时期-队列分析及趋势预测

王登辉, 刘伯鑫, 巨瑛, 何玉萍, 王秀梅, 师婧亚()   

  1. 710038 西安，空军军医大学唐都医院妇产科生殖医学中心
  • 收稿日期:2025-06-16 出版日期:2025-10-15 发布日期:2025-10-16
  • 通讯作者: 师婧亚 E-mail:376759769@qq.com

Age-Period-Cohort Analysis and Trend Prediction of the Disease Burden of Ectopic Pregnancy in China from 1990 to 2021

WANG Deng-hui, LIU Bo-xin, JU Ying, HE Yu-ping, WANG Xiu-mei, SHI Jing-ya()   

  1. Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, China
  • Received:2025-06-16 Published:2025-10-15 Online:2025-10-16
  • Contact: SHI Jing-ya E-mail:376759769@qq.com

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摘要：

目的： 分析中国1990—2021年异位妊娠疾病负担变化趋势，预测未来流行趋势，为优化防治策略提供依据。方法： 基于全球疾病负担（Global Burden of Disease，GBD）2021年数据，提取异位妊娠发病率、患病率和伤残调整寿命年（disability-adjusted life year，DALY）率等数据；采用Joinpoint回归分析时间趋势，年龄-时期-队列模型分析年龄、时期和队列效应，自回归移动平均数（autoregressive integrated moving average，ARIMA）模型预测2022—2036年疾病负担。结果： 2021年中国异位妊娠发病人数为152.59万例，比1990年减少了32.03%；患病人数为1.26万例，比1990年减少了31.89%；2021年异位妊娠造成的DALY为0.59万人年，比1990年减少了63.58%。年龄标化发病率（age-standardized incidence rate，ASIR）、年龄标化患病率（age-standardized prevalence rate，ASPR）、年龄标化DALY率（age-standardized DALY rate，ASDR）的平均年度百分比变化（average annual percentage change，AAPC）分别为-2.82%、-1.07%和-1.07%，差异有统计学意义（均P<0.001），总体呈下降趋势，但ASIR和ASPR在2010—2014年出现阶段性回升（年度百分比变化分别为6.45%和6.43%）。年龄效应显示，1990—2021年中国异位妊娠的DALY率随年龄增长呈先上升后下降趋势。时期效应显示，1992—2022年呈现下降趋势，RR值减少了0.83。队列效应显示，1935—1950年RR值较高，1955—2005年期间未发生明显变化。ARIMA模型预测结果显示，2022—2036年异位妊娠的ASIR、ASPR均呈上升趋势，ASDR呈下降趋势，其中ASDR从2021年的0.46/10万下降至2036年的0.12/10万；ASPR从0.91/10万升至1.08/10万，增长约18.68%；ASIR从110.95/10万增至130.62/10万，增幅达17.73%。结论： 1990—2021年中国异位妊娠疾病负担总体呈下降趋势，2010—2014年出现阶段性回升，预测未来ASIR和ASPR可能上升。当前疾病负担主要集中于30~34岁育龄女性，提示需重点关注高危年龄组（30~34岁）的避孕指导（如长效可逆避孕措施）和生殖健康管理，并加强针对高风险出生队列的筛查与基层诊疗能力，以应对未来可能的疾病负担回升。

关键词: 妊娠, 异位, 患病代价, 发病率, 患病率, 质量校正寿命

Abstract:

Objective: To analyze the changing trends of the disease burden of ectopic pregnancy in China from 1990 to 2021, predict its future epidemic trends, and provide a basis for optimizing prevention and control strategies. Methods: Based on the data from Global Burden of Disease (GBD) 2021, data such as the incidence rate, prevalence rate, and disability-adjusted life year (DALY) rate of ectopic pregnancy were extracted. Joinpoint regression analysis was used to analyze the time trends, The age-period-cohort model was used to analyze the age, period, and cohort effects, and the autoregressive integrated moving average (ARIMA) model was used to predict the disease burden from 2022 to 2036. Results: In 2021, the number of new cases of ectopic pregnancy in China was 1.525 9 million, a decrease of 32.03% compared with 1990; the number of prevalent cases was 12 600, a decrease of 31.89% compared with 1990; and DALY caused by ectopic pregnancy was 5 900 person-years, a decrease of 63.58% compared with 1990. The average annual percentage changes (AAPC) of the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), and age-standardized DALY rate (ASDR) were -2.82%, -1.07%, and -1.07%, respectively, with statistically significant differences (all P<0.001), showing an overall downward trend. However, the ASIR and ASPR showed a phased rebound from 2010 to 2014 (annual percentage changes were 6.45% and 6.43%). The age effect showed that from 1990 to 2021, the DALY rate of ectopic pregnancy in China first increased and then decreased with age. The period effects showed a downward trend from 1992 to 2022, with the relative risk (RR) value decreasing by 0.83. The cohort effect showed that the RR value was relatively high from 1935 to 1950, and there was no significant change from 1955 to 2005. The prediction results of the ARIMA model showed that from 2022 to 2036, the ASIR and ASPR of ectopic pregnancy would show an upward trend, while the ASDR would show a downward trend. The ASDR would decrease from 0.46 per 100 000 in 2021 to 0.12 per 100 000 in 2036, the ASPR would increase from 0.91 per 100 000 to 1.08 per 100 000, an increase of about 18.68%, and the ASIR would increase from 110.95 per 100 000 to 130.62 per 100 000, an increase of 17.73%. Conclusions: From 1990 to 2021, the disease burden of ectopic pregnancy in China showed an overall downward trend, with a phased rebound from 2010 to 2014. It is predicted that the ASIR and ASPR may increase in the future. Currently, the disease burden is mainly concentrated among women of child-bearing age aged 30-34, suggesting that contraceptive guidance (such as long-acting reversible contraceptive measures) and reproductive health management for high-risk age group (30-34 years old) should be emphasized and screening. Primary-level diagnosis and treatment capabilities for high-risk birth cohorts should be strengthened to cope with the possible rebound of the disease burden in the future.

Key words: Pregnancy, ectopic, Cost of illness, Incidence, Prevalence, Quality-adjusted life years