Archives of Gynecology and Obstetrics

, Volume 284, Issue 3, pp 579–586 | Cite as

Repeated medical abortions and the risk of preterm birth in the subsequent pregnancy

  • Hua Liao
  • Qiang Wei
  • Lijun Duan
  • Junli Ge
  • Yuanyang Zhou
  • Weiyue Zeng
Materno-fetal Medicine

Abstract

Purpose

The aim of this study was to determine the impact of repeated first trimester mifepristone-induced medical abortions on the risk of preterm birth in a subsequent pregnancy.

Methods

This is a pregnancy-based cohort study. Clinical data were collected from seven public hospitals in Chengdu, China from January 2006 to December 2009. Pregnant women with one or more first trimester mifepristone-induced medical abortions, and/or one or more surgical abortions, or no previous induced abortions were included in the study. The women were monitored through pregnancy and birth. Samples for analysis included 18,024 singleton births.

Results

The risk of preterm birth among women with one or more first trimester mifepristone-induced abortions did not differ significantly from the risk among primigravida women (OR 1.03, 95% confidence interval 0.53–1.63). The risks of preterm birth were higher among women with repeated surgical abortions in comparison to women with repeated medical abortions (OR 1.22, 95% confidence interval 1.03–1.64).

Conclusions

A history of multiple first trimester mifepristone-induced abortions is not associated with a higher risk of preterm delivery among singleton births in the first subsequent pregnancy.

Keywords

Medical abortion Preterm birth Repeated induced abortions Mifepristone 

References

  1. 1.
    WHO (2003) Safe abortion: technical and policy guidance for health systems (accessed 23 June 2010). http://www.who.int/reproductivehealth/publications/unsafe_abortion/9241590343/en/
  2. 2.
    Ministry of health of the people’s republic of China (2009) China health statistical yearbook 2009. Peking Union Medical College Press, BeijingGoogle Scholar
  3. 3.
    Yimin C, Wei Y, Weidong C, Xianmi W, Junqing W, Lin L (2004) Mifepristone-induced abortion and birth weight in the first subsequent pregnancy. Int J Gynecol Obstet 84:229–235. doi:10.1016/S0020-7292(03)00338-2 CrossRefGoogle Scholar
  4. 4.
    Løkeland M, Iversen OE, Dahle GS, Nappen MH, Ertzeid L, Bjørge L (2010) Medical abortion at 63 to 90 days of gestation. Obstet Gynecol 115:962–968. doi:10.1097/AOG.0b013e3181da0c3e PubMedCrossRefGoogle Scholar
  5. 5.
    National Institute for Health and Welfare (2009) Induced abortions (accessed 12 May 2010). http://www.stakes.fi/EN/tilastot/statisticsbytopic/reproduction/abortions.htm
  6. 6.
    National Health Service, Department of Health (2007) Abortion statistics, England and Wales, 2006 (accessed 5 June 2010). http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697
  7. 7.
    Jones RK, Zolna MR, Henshaw SK, Finer LB (2008) Abortion in the United States: incidence and access to services, 2005. Perspect Sex Reprod Health 40:6–16. doi:10.1363/4000608 PubMedCrossRefGoogle Scholar
  8. 8.
    Cheng Y, Xu X, Xu J, Wuillaume F, Zhu J, Gibson D et al (2008) The need for integrating family planning and postabortion care in China. Int J Gynecol Obstet 103:140–143. doi:10.1016/j.ijgo.2008.06.013 CrossRefGoogle Scholar
  9. 9.
    Heikinheimo O, Gissler M, Suhonen S (2008) Age, parity, history of abortion and contraceptive choices affect the risk of repeat abortion. Contraception 78:149–154. doi:10.1016/j.contraception.2008.03.013 PubMedCrossRefGoogle Scholar
  10. 10.
    Elam-Evans LD, Strauss LT, Herndon J, Parker WY, Whitehead S, Berg CJ (2002) Abortion surveillance—United States, 1999. MMWR Surveill Summ 51:1–28PubMedGoogle Scholar
  11. 11.
    Statistics Canada, Therapeutic Abortion Survey (2003) Canadian Institute for Health Information (custom tabulation). Statistics Canada, OttawaGoogle Scholar
  12. 12.
    Cheng Y, Guo X, Li Y, Li S, Qu A, Kang B (2004) Repeat induced abortions and contraceptive practices among unmarried young women seeking an abortion in China. Int J Gynecol Obstet 87:199–202. doi:10.1016/j.ijgo.2004.06.010 CrossRefGoogle Scholar
  13. 13.
    Buchmayer SM, Sparén P, Cnattingius S (2004) Previous pregnancy loss: risks related to severity of preterm delivery. Am J Obstet Gynecol 191:1225–1231. doi:10.1016/j.ajog.2004.02.066 PubMedCrossRefGoogle Scholar
  14. 14.
    Basso O, Olsen J, Christensen K (1998) Risk of preterm delivery, low birthweight and growth retardation following spontaneous abortion: a registry-based study in Denmark. Int J Epidemiol 27:642–646PubMedCrossRefGoogle Scholar
  15. 15.
    Swingle HM, Colaizy TT, Zimmerman MB, Morriss FH Jr (2009) Abortion and the risk of subsequent preterm birth: a systematic review with meta-analyses. J Reprod Med 54:95–108PubMedGoogle Scholar
  16. 16.
    Ancel PY, Lelong N, Papiernik E, Saurel MJ, Kaminski M (2004) History of induced abortion as a risk factor for preterm birth in European countries: results of the EUROPOP survey. Hum Reprod 19:734–740. doi:10.1093/humrep/deh107 PubMedCrossRefGoogle Scholar
  17. 17.
    Shah PS, Zao J (2009) Induced termination of pregnancy and low birthweight and preterm birth: a systematic review and meta-analyses. BJOG 116:1425–1442. doi:10.1111/j.1471-0528.2009.02278.x PubMedCrossRefGoogle Scholar
  18. 18.
    Virk J, Zhang J, Olsen J (2007) Medical abortion and the risk of subsequent adverse pregnancy outcomes. N Engl J Med 357:648–653PubMedCrossRefGoogle Scholar
  19. 19.
    Miao MH, Gao ES, Chen AM, Luo L, Cheng YM, Yuan W (2010) Mifepristone-induced abortion and duration of third stage labour in a subsequent pregnancy. Paediatr Perinat Epidemiol 24:125–130. doi:10.1111/j.1365-3016.2010.01102.x PubMedCrossRefGoogle Scholar
  20. 20.
    Collier J (2009) The rising proportion of repeat teenage pregnancies in young women presenting for termination of pregnancy from 1991 to 2007. Contraception 79:393–396. doi:10.1016/j.contraception.2008.11.014 PubMedCrossRefGoogle Scholar
  21. 21.
    Zhou W, Sørensen HT, Olsen J (1999) Induced abortion and subsequent pregnancy duration. Obstet Gynecol 94:948–953PubMedCrossRefGoogle Scholar
  22. 22.
    Henriet L, Kaminski M (2001) Impact of induced abortions on subsequent pregnancy outcome: the 1995 French national perinatal survey. BJOG 108:1036–1042. doi:10.1111/j.1471-0528.2001.00243.x PubMedCrossRefGoogle Scholar
  23. 23.
    Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G et al (2005) Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study. BJOG 112:430–437. doi:10.1111/j.1471-0528.2004.00478.x PubMedCrossRefGoogle Scholar
  24. 24.
    Freak-Poli R, Chan A, Tucker G, Street J (2009) Previous abortion and risk of pre-term birth: a population study. J Matern Fetal Neonatal Med 22:1–7. doi:10.1080/14767050802531813 PubMedCrossRefGoogle Scholar
  25. 25.
    Allen RH, Westhoff C, De Nonno L, Fielding SL, Schaff EA (2001) Curettage after mifepristone-induced abortion: frequency, timing, and indications. Obstet Gynecol 98:101–106PubMedCrossRefGoogle Scholar
  26. 26.
    Jensen JT, Astley SJ, Morgan E, Nichols MD (1999) Outcomes of suction curettage and mifepristone abortion in the United States: a prospective comparison study. Contraception 59:153–159PubMedCrossRefGoogle Scholar
  27. 27.
    Chen A, Yuan W, Meirik O, Wang X, Wu SZ, Zhou L et al (2004) Mifepristone-induced early abortion and outcome of subsequent wanted pregnancy. Am J Epidemiol 160:110–117. doi:10.1093/aje/kwh182 PubMedCrossRefGoogle Scholar
  28. 28.
    Liang M, Zhu Q, Gao E, Chen A, Luo L, Cheng Y et al (2008) Clinical study on the relationship between curettage after medical abortion and labor complications of subsequent pregnancy (in Chinese). Chin J Fam Plann 16:679–682Google Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Hua Liao
    • 1
  • Qiang Wei
    • 1
  • Lijun Duan
    • 1
  • Junli Ge
    • 1
  • Yuanyang Zhou
    • 1
  • Weiyue Zeng
    • 1
  1. 1.Department of Obstetrics and GynecologyWest China Second University Hospital, Sichuan UniversityChengduPeople’s Republic of China

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