Induced abortion - impact on a subsequent pregnancy in first-time mothers: a registry-based study

Abstract

BackgroundTo date, several studies concerning the effects of induced abortion (IA) on women’s later psychosocial well-being and future delivery complications have been published. However, the lack of reports on woman’s physical well-being during their first full-term pregnancy occurring after IA is what inspired the current study. Here, we evaluate the physical well-being and use of maternity services of first-time mothers with a history of IA.MethodsFinnish National Birth Registry data from 2008 to 2010 were linked with the Induced Abortion Registry data from 1983 to 2007. After excluding first-time mothers with a history of miscarriage, ectopic pregnancy or delivery, 57,406 mothers were eligible for the study, with 5,167 (9.0 %) having experienced prior IA. Data from the pregnancy follow-up visits were evaluated and compared between IA mothers and primiparous mothers.ResultsWomen with IA had higher rates of smoking after the first trimester and were more likely to be overweight (body mass index >25 kg/m2) than the control group mothers. A higher use of maternity health clinic (MHC) services, thrombosis prophylaxis and participation in a second trimester ultrasound and amniotic fluid sample testing were evident in IA mothers, whereas the likelihood of assisted fertilisation procedure(s) was elevated in the control group. A shorter interpregnancy interval (IPI) seemed to contribute to a late first MHC visit and first trimester serum screening test participation, a higher incidence of placenta samples and an increased presence of preeclampsia and maternal care for poor foetal growth.ConclusionsIA is associated with being overweight before the subsequent pregnancy and with smoking after the first trimester. More frequent pregnancy follow-up visits in the IA group may be due to greater participation in the placenta sample testing and use of thrombosis prophylaxis. No association between IA and preeclampsia, hypertension, gestational diabetes or preterm premature rupture of membranes was evident in the pregnancy parameters. According to our findings, experiencing IA decreased the need for fertilisation procedures before the next pregnancy when compared to primiparous mothers. Among the IA mothers, the short IPI seemed to contribute to the higher risk for preeclampsia and maternal care for poor foetal growth. However, more research is needed around the IPI before establishing its effect on later pregnancy.

Association between previous spontaneous abortion and preeclampsia: a case–control study

“…Interestingly, while one prior miscarriage was not found to be associated with preeclampsia, two or more miscarriages were found to be associated with increased risks of preeclampsia [ 7 ]. On the other hand, Holmlund et al found no association between induced abortion and preeclampsia in Finland [ 9 ]. Moreover, Clark et al reported no association between miscarriage and gestational hypertension, even in women with more than two abortions [ 10 ].…”

“…However, the results of these studies are inconsistent; while some studies have reported an increased risk of preeclampsia in women with a history of abortions [ 5 – 8 ], others have reported no such effect [ 9 – 12 ] or a reduced risk of preeclampsia in women with a history of abortions [ 13 – 16 ]. Moreover, most these studies have been conducted in high-income countries [ 7 , 9 , 13 , 16 ]. There is a scarcity of data on the history of abortion and preeclampsia in sub-Saharan African countries [ 6 ], and none of these studies have been conducted in Sudan.…”

“…Several studies have reported an association between prior abortion and preeclampsia [5][6][7][8][9][10][11][12][13][14][15][16]. However, the results of these studies are inconsistent; while some studies have reported an increased risk of preeclampsia in women with a history of abortions [5][6][7][8], others have reported no such effect [9][10][11][12] or a reduced risk of preeclampsia in women with a history of abortions [13][14][15][16]. Moreover, most these studies have been conducted in high-income countries [7,9,13,16].…”

Association of induced abortion with preterm birth risk in first-time mothers

“…The inconsistency that emerged among the studies can at least partially be explained by differences in study design or power, by multiple comparisons, by recall bias and by differences in the methods used to perform IA at different times and in different countries. Additionally, epidemiological studies have been showed that revision of the uterine cavity might be responsible for endometritis, which is more likely to be the result of traumatic procedures 25 , 38 . This could also contribute to the differences in several studies.…”

Mythen zum Schwangerschaftsabbruch

“…Das Risiko für häufigere Fehlgeburten oder eine Plazenta praevia ist nicht erhöht[10].Das finnische Geburtsregister analysierte die Daten zwischen 2008 und 2010 von 57.406 Frauen kombiniert mit dem SAB-Register von 1983-2007 mit 5.167 Frauen. Es gab keine statistisch relevanten Unterschiede bezüglich der folgenden Schwangerschaft, Blutungen, schwangerschaftsinduziertem Hypertonus, Frühgeburtlichkeit, Anämie und vorgeburtlicher Kortisongabe[11].17.4 Mythos 4: Nach einer Abtreibung gibt es Probleme wieder ……”