Afifa Intifadha Habibatullah. S022102002. 2022. Meta-Analisis Pengaruh Endometriosis dan Penggunaan Alat Kontrasepsi dalam Rahim terhadap Kejadian Kehamilan Ektopik. Tesis. Pembimbing I: Dr. Uki Retno Budihastuti, dr., Sp.OG(K). Pembimbing II: Vitri Widyaningsih, dr., MS., Ph.D. Program Studi Ilmu Kesehatan Masyarakat. Pascasarjana. Universitas Sebelas Maret.

Latar Belakang: Kehamilan ektopik merupakan komplikasi awal kehamilan dengan morbiditas dan mortalitas yang tinggi. Beberapa studi telah meneliti riwayat endometriosis dan penggunaan AKDR sebagai faktor risiko kehamilan ektopik, namun menunjukkan hasil yang berbeda-beda. Penelitian ini bertujuan untuk menganalisis besar pengaruh riwayat endometriosis dan penggunaan AKDR terhadap kejadian kehamilan ektopik dengan studi meta-analisis.
Subjek dan Metode: Penelitian ini merupakan systematic review dan meta-analisis yang dilakukan dengan pedoman PRISMA flow diagram. Proses pencarian artikel dilakukan pada database PubMed, Google Scholar, Science Direct, SAGE, JSTOR, dan Scopus, untuk artikel yang diterbitkan dari 2005 hingga 2022. Kata kunci yang digunakan yaitu: “Endometriosis” AND “Intrauterine Contraceptive Device” OR “Intrauterine Device” OR “IUD” OR “IUCD” AND “Ectopic Pregnancy” OR “Extrauterine Pregnancy” OR “Tubal Pregnancy” OR “Pregnancy Outcomes” OR “Pregnancy Complications” AND “Multivariate” OR “Multivariable” OR “Adjusted Odds Ratio” OR “aOR”. Analisis dilakukan dengan perangkat lunak RevMan 5.3.
Hasil: Sebanyak 11 artikel dinyatakan memenuhi kriteria dan dimasukkan ke dalam meta-analisis. Hasil keseluruhan analisis 4 artikel yang terdiri dari 2 studi kohor dan 2 case-control yaitu endometriosis meningkatkan risiko kejadian kehamilan ektopik 1.39 kali lipat dibandingkan tanpa endometriosis (aOR = 1.39, CI 95% = 1.16-1.68; p < 0 xss=removed xss=removed xss=removed>Kesimpulan: Endometriosis merupakan faktor risiko kehamilan ektopik. Penggunaan AKDR meningkatkan risiko kehamilan ektopik namun tidak signifikan secara statistik.

Background: Ectopic pregnancy is an early-pregnancy complication with high morbidity and mortality. Prior studies have investigated endometriosis and IUD use as risk factors of ectopic pregnancy but showed different results. This study aimed to analyze the volume of effects of endometriosis and IUD use on ectopic pregnancy using meta-analysis.
Subject dan Method: This systematic review and meta-analysis study was performed using the PRISMA flow diagram. Articles from 2005-2022 were explored from these following databases: PubMed, Google Scholar, Science Direct, SAGE, JSTOR, and Scopus. Keywords used in article explorations were: “Endometriosis” AND “Intrauterine Contraceptive Device” OR “Intrauterine Device” OR “IUD” OR “IUCD” AND “Ectopic Pregnancy” OR “Extrauterine Pregnancy” OR “Tubal Pregnancy” OR “Pregnancy Outcomes” OR “Pregnancy Complications” AND “Multivariate” OR “Multivariable” OR “Adjusted Odds Ratio” OR “aOR”. The data then analyzed using the RevMan 5.3 software.
Results: A total of 11 articles were reviewed and included in this meta-analysis. The overall results of 4 studies consisting of 2 cohort and 2 case-control studies showed that women with endometriosis had 1.39 times more risk on developing ectopic pregnancy compared to women without endometriosis (aOR = 1.39, CI 95% = 1.16-1.68; p = 0.0005). The analysis of 7 case-control studies showed that IUD use in women increased the risk of ectopic pregnancy by 1.35 times but not statistically significant (aOR= 1.35, CI 95% = 0.45-4.03; p = 0.59).
Conclusion: Endometriosis is a risk factor for ectopic pregnancy. IUD use increases the risk of developing ectopic pregnancy but not statistically significant.