Induced Abortions and the Risk of Preeclampsia Among Nulliparous Women

Parker, Samantha E.; Gissler, Mika; Ananth, Cande V.; Werler, Martha M.

doi:10.1093/aje/kwv184

Cited by 17 publications

(14 citation statements)

References 33 publications

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“…No studies reported among the high-risk group, but within the pregnant women, various studies reported that prior abortion as a protective factor from developing PE 10,11 . Analogous to our findings, previous studies have reported the protective effect of both induced [10][11][12][13][14] and spontaneous abortions 12,15,16 . The reason is unclear.…”

Section: Discussionsupporting

confidence: 92%

Incidence and risk factors for preeclampsia in a cohort of high-risk pregnant women: a nested case-control study from South India

Madhavan¹,

Pal²,

Pal³

et al. 2020

Preprint

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Objective: To explore the incidence and risk factors of preeclampsia (PE) among high-risk pregnant women in South India. Design: Nested case-control study Setting: Tertiary referral hospital Population or Sample: Pregnant women with risk for PE. Methods: Maternal characteristics were prospectively collected, and risk factors were assessed comparatively between women with risk for developing PE and normotensive pregnant women using risk ratio (RR) (95% CI) plus multivariate analysis. One hundred and seventy-four risk group pregnant women were followed-up once in each trimester till delivery and noted for the development of PE. Main Outcome Measures: Incidence and risk factors of PE among high-risk pregnant women. Results: 67/174 women developed PE, corresponding to an incidence of 38.51% among pregnant women with risk for PE. Women in the age group of 30 and older reported a higher incidence. Maternal factors like absence of a family history of chronic hypertension, history of abortion, non-consanguineous marriage, and AB blood group were significant protective factor and sex of the newborn being female was a significant risk factor for developing PE. Conclusion: This is the first Indian study that explored the incidence and risk factors for PE among high-risk pregnant women. Incidence of PE was higher among South Indian risk population. Female infants significantly contributed to the PE risk.

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Section: Discussionsupporting

confidence: 92%

Incidence and risk factors for preeclampsia in a cohort of high-risk pregnant women: a nested case-control study from South India

Madhavan¹,

Pal²,

Pal³

et al. 2020

Preprint

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“…Previous studies in Ghana [ 21 ] and Mozambique [ 34 ] have reported the same. Parker et al [ 57 ] explained this by linking pregnancy to preeclampsia which is estimated to affect 4%–8% of first pregnancies. They explained that women who suffer from preeclampsia and other pregnancy related complications may experience situations that may require termination of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

What has women’s reproductive health decision-making capacity and other factors got to do with pregnancy termination in sub-Saharan Africa? evidence from 27 cross-sectional surveys

et al. 2020

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Introduction Pregnancy termination is one of the key issues that require urgent attention in achieving the third Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being for all at all ages. The reproductive health decision-making (RHDM) capacity of women plays a key role in their reproductive health outcomes, including pregnancy termination. Based on this premise, we examined RHDM capacity and pregnancy termination among women of reproductive age in sub-Saharan Africa (SSA). Materials and methods We pooled data from the women’s files of the most recent Demographic and Health Surveys (DHS) of 27 countries in SSA, which are part of the DHS programme. The total sample was 240,489 women aged 15 to 49. We calculated the overall prevalence of pregnancy termination in the 27 countries as well as the prevalence in each individual country. We also examined the association between RHDM capacity, socio-demographic characteristics and pregnancy termination. RHDM was generated from two variables: decision-making on sexual intercourse and decision-making on condom use. Binary logistic regression analysis was conducted and presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals (CI). Statistical significance was declared p<0.05. Results The prevalence of pregnancy termination ranged from 7.5% in Benin to 39.5% in Gabon with an average of 16.5%. Women who were capable of taking reproductive health decisions had higher odds of terminating a pregnancy than those who were incapable (AOR = 1.20, 95% CI = 1.17–1.24). We also found that women aged 45–49 (AOR = 5.54, 95% CI = 5.11–6.01), women with primary level of education (AOR = 1.14, 95% CI = 1.20–1.17), those cohabiting (AOR = 1.08, 95% CI = 1.04–1.11), those in the richest wealth quintile (AOR = 1.06, 95% CI = 1.02–1.11) and women employed in the services sector (AOR = 1.35, 95% CI = 1.27–1.44) were more likely to terminate pregnancies. Relatedly, women who did not intend to use contraceptive (AOR = 1.47, 95% CI = 1.39–1.56), those who knew only folkloric contraceptive method (AOR = 1.25, 95% CI = 1.18–1.32), women who watched television almost every day (AOR = 1.16, 95% CI = 1.20–1.24) and those who listened to radio almost every day (AOR = 1.11, 95% CI = 1.04–1.18) had higher odds of terminating a pregnancy. However, women with four or more children had the lowest odds (AOR = 0.5, 95% CI = 0.54–0.60) of terminating a pregnancy. Conclusion We found that women who are capable of taking reproductive health decisions are more likely to terminate pregnancies. Our findings also suggest that age, level of education, contraceptive use and intention, place of residence, and parity are associated with pregnancy termination. Our findings call for the implementation of policies or the strengthening of existing ones to empower women about RHDM capacity. Such empowerment could have a positive impac...

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“…According to previous studies, repeated IAs may cause uterine adhesion, placenta previa, and pelvic inflammation, which impact subsequent pregnancies [8]. However, studies have shown a lower risk of PE associated with IAs in primiparous women [9][10][11][12][13]. A history of light endometrium injuries, such as biopsy and curettage may increase the success rate of implantation in assisted reproductive techniques [14].…”

Section: Introductionmentioning

confidence: 99%

“…It seems that among women with a prior IA or shorter interpregnancy interval, maternal immunological recognition of trophoblast may be improved, which may contribute toward placentation and uteroplacental perfusion. Parker et al [12] speculated that the inflammatory response to IA improves placentation and reduces the risk of PE. However, the pregnancy itself may change the uterine immunological environment, which may contribute to the maternal-fetal crosstalk in the subsequent pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Human Uterine Decidual NK Cells in Women with a History of Early Pregnancy Enhance Angiogenesis and Trophoblast Invasion

Jia

2020

BioMed Research International

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Objective. The present study aimed to identify changes in decidual natural killer (dNK) cells and related cytokines in women who have undergone induced abortions (IAs). The effects of dNK cells on subsequent pregnancies remain unknown. Accordingly, we sought to investigate whether a history of early pregnancy can change dNK cells and facilitate their role in the regulation of angiogenesis and trophoblast invasion. Materials and Methods. dNK cells were obtained from primiparous women who had undergone IA(s) prior to this study and primiparous women who had never been pregnant before this IA (control). Real-time polymerase chain reaction (PCR) was used to measure the mRNA levels of IFN-γ, IP-10, VEGF, and PLGF in dNK cells. The levels of these cytokines were quantified using the enzyme-linked immunosorbent assay. HUVEC and HTR-8/SVneo cells were used to evaluate the angiogenesis, migration, and invasion activities influenced by dNK cells. Results. In dNK cells, the mRNA level of IFN-γ was higher in the control group than that in the IA group. The secretion of IP-10 and VEGF was higher in the IA group compared to the control group. After coculturing with the dNK supernatant, the HTR-8/SVneo cells exhibited better invasiveness and migration in the IA group than those in the control group. Angiogenesis assay demonstrated that dNK cells from IA group might help HUVEC attain better tube formation ability. Conclusion. The findings of this study suggest that a history of early pregnancy has an impact on dNK cells. These trained dNK cells can regulate angiogenesis and trophoblast invasion and migration by promoting the production of certain cytokines.

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Induced Abortions and the Risk of Preeclampsia Among Nulliparous Women

Cited by 17 publications

References 33 publications

Incidence and risk factors for preeclampsia in a cohort of high-risk pregnant women: a nested case-control study from South India

Incidence and risk factors for preeclampsia in a cohort of high-risk pregnant women: a nested case-control study from South India

What has women’s reproductive health decision-making capacity and other factors got to do with pregnancy termination in sub-Saharan Africa? evidence from 27 cross-sectional surveys

Human Uterine Decidual NK Cells in Women with a History of Early Pregnancy Enhance Angiogenesis and Trophoblast Invasion

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