Abstract
Purpose: The aim of this study was to evaluate white blood cell (WBC) count as a risk factor related to methotrexate (MTX) treatment failure in patients with ectopic pregnancy (EP).Methods: A total of 236 women diagnosed with EP and treated with a single dose of MTX were included. The exposure variable was WBC count at baseline, and the outcome was MTX treatment outcome. Both a multivariate binary logistics regression model and subgroup analysis were performed to evaluate the association between WBC and MTX non-response.Results: WBC count was associated with the risk of treatment failure, and the odds ratio (OR) in different multivariate models was stable [minimally adjusted model: OR 1.2, 95% confidence interval (CI): 1.0–1.3, p = 0.008; fully adjusted model: OR 1.2, 95% CI: 1.0–1.4, p = 0.026]. For WBCs in group T3 (>8.9 × 109/L), the association between WBC count and treatment failure was significant (minimally adjusted model: OR: 2.0, 95% CI: 1.0–3.8, p = 0.050; fully adjusted model: OR: 2.2, 95% CI: 1.1–5.6, p = 0.034). Subgroup analysis showed that in participants with regular menstruation (OR 1.1, 95% CI: 1.0–1.3), WBC count was significantly different from irregular menstruation (OR 1.8, 95% CI: 1.2–2.8); p for interaction was 0.031.Conclusions: We found a reliable and non-linear relationship between WBC count and MTX treatment failure for EP.
Highlights
Ectopic pregnancy (EP) refers to the implantation of fertilized eggs outside the uterine cavity
white blood cell (WBC) count was associated with the risk of treatment failure, and the odds ratio (OR) in different multivariate models was stable [minimally adjusted model: OR 1.2, 95% confidence interval (CI): 1.0–1.3, p = 0.008; fully adjusted model: OR 1.2, 95% CI: 1.0–1.4, p = 0.026]
For WBCs in group T3 (>8.9 × 109/L), the association between WBC count and treatment failure was significant
Summary
Ectopic pregnancy (EP) refers to the implantation of fertilized eggs outside the uterine cavity. Based on the 2018 American College of Obstetricians and Gynecologists (ACOG) guidelines, EP occurs in about 2% of all pregnancies and causes 2.7% of all pregnancy-related deaths [1]. It is one of the main causes of hemorrhagic shock and death in pregnant women [2]. Treatments for EP mainly include surgery and drug therapy. Drug therapy has the advantages of avoiding surgical complications and iatrogenic trauma as well as preserving the fallopian tubes (FT) to offer a higher chance of conception for those with fertility requirements.
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