Is induced abortion a risk factor in subsequent pregnancy?

Abstract

Objective: To determine whether a history of terminations of pregnancy influences subsequent pregnancies in terms of pregnancy risks, prematurity and neonatal biometrics. Patients and methods:Based on the perinatal statistics of eight German federal states, data of 247,593 primiparous women with singleton pregnancies born between 1998 and 2000 were analyzed. The control group consisted of primiparous women without previous induced abortions. Maternal age was adjusted for. Results: There was an overall trend towards an increased rate of preterm delivery at F36 weeks' gestation and early preterm delivery at F31 weeks' gestation in women who had previous pregnancy terminations. For the cohort of 28-30 years, the observed rates of prematurity in women with one and with G2 previous induced abortions were 7.8% and 8.5%, respectively, compared to 6.5% in the control population (Ps0.015). Preceding terminations of pregnancy did not alter the rate of small-for-gestational-age newborns. Psychosocial stress and symptoms associated with prematurity such as cervical incompetence and vaginal bleeding before and after 28 weeks of gestation occurred more frequently in women with previous induced abortion compared to the control group (P-0.0001). Conclusion:The rate of preterm births increases with the number of preceding abortions. Similarly, symptoms *Corresponding author: PD Dr. Dr. rer. med. habil. Manfred Voigt Department of Obstetrics and Gynecology Ernst-Moritz-Arndt University of Greifswald Wollweberstrasse 1-3 17475 Greifswald Germany E-mail: manfred.voigt@kliniksued-rostock.de associated with prematurity are more common. The rate of small-for-gestational-age newborns was not affected by preceding terminations of pregnancy.

Risks of Adverse Perinatal Outcomes after Repeat Terminations of Pregnancy by their Methods: a Nationwide Register‐based Cohort Study in Finland 1996–2013

“…In keeping line with earlier studies, we found the demographic characteristics of the first‐time mothers who had previous induced TOP different from those first‐time mothers having no history of induced TOP. As in previous studies, during the time period where most of the induced TOPs were surgical, our study found an increased risk for extremely preterm birth among the women with at least two surgical induced TOPs compared to the women with no history of induced TOP. In contrast to some previous studies, we did not find any significant increased risk for preterm birth after one surgical or medical induced TOP; however, this is similar to the finding of a previous study from Finland .…”

Adverse Pregnancy Outcomes among Women with Prior Spontaneous or Induced Abortions

“…10 Moreover, the results of our study are consistent with the findings of others reporting an increased risk of adverse outcomes in women with a prior IAB. 4,10,[21][22][23][24] Chen et al found lower odds for preterm delivery in women with one mifepristone abortion compared with women with no abortion. 25 Reasons for the association between both SAB and IAB and subsequent PTB are unclear.…”

Health disparities in risk for cervical insufficiency

“…Although findings on the association between prior pregnancy termination and subsequent preterm delivery have been mixed (Pickering and Forbes, 1985; Henriet and Kaminski, 2001; Moreau et al ., 2005; Raatikainen et al ., 2006; Virk et al ., 2007; Brown et al ., 2008; Voigt et al ., 2008, 2009; Freak-Poli et al ., 2009), the observed ‘dose–response relationship’ between number of pregnancy terminations and preterm risk, as demonstrated in a recent meta-analysis by Shah and Zao (2009) provides strong evidence in favor of an association between pregnancy termination and preterm birth. The strong association between prior pregnancy termination and cervical insufficiency irrespective of race/ethnicity was confirmed in our analysis.…”