The Trajectory of Fertility and Life Quality in Reproductive-Aged Patients after Tubal Pregnancy Surgery and Its Relationship with Reproductive Concerns

doi:10.12280/gjszjk.20250474

Abstract

Abstract:

Objective: To explore the change trajectory of fertility and life quality in the reproductive-aged patients after tubal surgery due to ectopic pregnancy, and analyze the relationship with fertility anxiety. Methods: A convenient sampling method was used to select 234 reproductive-aged patients with ectopic pregnancy, who were admitted to the First Affiliated Hospital with Nanjing Medical University from January 2022 to June 2024 as the research subjects. All patients were surveyed using The Fertility Quality of Life (FertiQoL) Scale at 1 week(T₁), 4 weeks(T₂), 8 weeks(T₃), 12 weeks(T₄), and 16 weeks(T₅) after tubal pregnancy surgery. At 16 weeks postoperatively(T₅), the level of postoperative fertility anxiety was surveyed using the Chinese version of the Reproductive Concerns After Cancer Scale(RCAC). A latent class growth model was applied to identify the potential categories of trajectories in the fertility and life quality, and analysis of variance was used to explore the differences in the fertility anxiety score among reproductive-aged patients with ectopic pregnancy across different potential categories of fertility and life quality. Results: The FertiQoL scores of reproductive-aged patients with ectopic pregnancy at different time points (T₁ to T₅) after tubal surgery were 27-53 (39.16±4.26), 28-65 (45.50±6.69), 43-92 (65.53±9.40), 50-90 (70.20±7.82), and 51-97 (74.02±8.81), respectively. The latent category growth model identified 3 types of trajectory types of change in fertility and life quality in reproductive-aged patients after tubal surgery due to ectopic pregnancy, with 33.33% in the low fertility quality of life-steady increase group (A1), 40.60% in the medium fertility quality of life-improvement significant group (A2), and 26.07% in the high fertility quality of life-rapid increase group (A3). In multivariable analyses using the A1 group as the referent, age<35 years (vs. 35-45 years) was significantly associated with increased odds of belonging to the A2 group (OR=2.558). Factors associated with the A1 group included residence in towns (OR=0.256), rural areas (OR=0.185), and having no fertility intention (OR=0.476). Similarly, age<35 years was associated with the A3 group (OR=2.324), while rural residence (OR=0.119) and no fertility intention (OR=0.212) were associated with the A1 group (all P<0.05). The comparison of the 3 latent categories of RCAC scores showed a significant difference(F=2 327.324, P<0.001). Conclusions: It is suggested that those tubal pregnancy patients with low fertility-related quality of life should be focused in clinical practice. Various forms such as internet platforms, public welfare lectures and news media should be used to strengthen the popularization of knowledge on the treatment and nursing of ectopic pregnancy, especially tubal pregnancy, so as to improve the awareness, understanding and tolerance of key groups including patients, their family members and women with fertility needs towards ectopic pregnancy. In addition, psychological counseling for those patients should be strengthened to reduce their fertility anxiety and improve their fertility-related quality of life.

Key words: Pregnancy, ectopic, Pregnancy, tubal, Quality of life, Fertility, Family planning services, Latent class analysis

SHAO Rong, JIANG Tao, CHEN Xing. The Trajectory of Fertility and Life Quality in Reproductive-Aged Patients after Tubal Pregnancy Surgery and Its Relationship with Reproductive Concerns[J]. Journal of International Reproductive Health/Family Planning, 2025, 44(6): 453-458.

Figures/Tables 6

References 23

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类别	aBIC	BIC	AIC	Entropy	LMRT（P）	BLRT（P）	类别概率
1	5 652.472	5 682.458	5 637.524	-	-	-	1
2	5 417.539	5 264.247	5 427.297	0.795	<0.001	<0.001	0.724/0.276
3	5 197.007	4 972.627	5 271.223	0.824	0.005	<0.001	0.406/0.261/0.333
4	4 922.541	5 057.147	4 980.672	0.841	0.123	<0.001	0.345/0.279/0.114/0.262
5	4 737.287	5 106.525	4 711.152	0.904	0.249	0.065	0.267/0.605/0.076/0.052

类别	aBIC	BIC	AIC	Entropy	LMRT（P）	BLRT（P）	类别概率
1	5 652.472	5 682.458	5 637.524	-	-	-	1
2	5 417.539	5 264.247	5 427.297	0.795	<0.001	<0.001	0.724/0.276
3	5 197.007	4 972.627	5 271.223	0.824	0.005	<0.001	0.406/0.261/0.333
4	4 922.541	5 057.147	4 980.672	0.841	0.123	<0.001	0.345/0.279/0.114/0.262
5	4 737.287	5 106.525	4 711.152	0.904	0.249	0.065	0.267/0.605/0.076/0.052

组别	n	T₁	T₂	T₃	T₄	T₅
A1组	78	37.68±3.08	39.85±4.57	56.18±5.76	64.27±5.68	67.64±5.18
A2组	95	39.26±5.34	45.76±5.59	67.85±7.84	70.59±7.09	73.54±8.56
A3组	61	41.26±2.68	52.54±3.28	73.54±4.49	77.21±4.87	82.93±4.22

组别	n	T₁	T₂	T₃	T₄	T₅
A1组	78	37.68±3.08	39.85±4.57	56.18±5.76	64.27±5.68	67.64±5.18
A2组	95	39.26±5.34	45.76±5.59	67.85±7.84	70.59±7.09	73.54±8.56
A3组	61	41.26±2.68	52.54±3.28	73.54±4.49	77.21±4.87	82.93±4.22

项目	A1组（n=78）	A2组（n=95）	A3组（n=61）	χ²	P
年龄（岁）				9.834	0.007
35~45	41（52.56）	30（31.58）	19（31.15）
<35	37（47.44）	65（68.42）	42（68.85）
婚姻状况				2.756	0.252
初婚	66（84.62）	85（89.47）	57（93.44）
再婚	12（15.38）	10（10.53）	4（6.56）
文化程度				5.134	0.240
专科及本科	27（42.31）	20（21.05）	21（34.43）
高中	38（48.72）	58（61.05）	30（49.18）
初中及以下	13（16.67）	17（17.90）	10（16.39）
年收入（万元）				2.009	0.734
<5	19（24.36）	18（18.95）	12（19.67）
5~10	44（56.41）	51（53.68）	33（54.10）
>10	15（19.23）	26（27.37）	16（26.23）
职业状态				9.219	0.056
在职	30（38.46）	52（54.74）	26（42.62）
未工作	17（21.80）	22（23.16）	10（16.39）
尚未返岗	31（39.74）	21（22.10）	25（40.99）
居住地				27.228	0.004
农村	26（33.33）	10（10.53）	4（6.56）
城镇	12（15.39）	8（8.42）	11（18.03）
市区	40（51.28）	77（81.05）	46（75.41）
既往异位妊娠史				3.444	0.179
有	6（7.69）	3（3.16）	1（1.64）
无	72（92.31）	92（96.84）	60（98.36）
生育意愿				11.206	0.004
有	50（64.10）	73（76.84）	54（88.52）
无	28（35.90）	22（23.16）	7（11.48）
子女数量（个）				5.903	0.207
0	50（64.10）	54（56.84）	46（75.41）
1	20（25.64）	31（32.63）	12（19.67）
≥2	8（10.26）	10（10.53）	3（4.92）