Skip to main content
Log in

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

  • Materno-fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  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. Ministry of health of the people’s republic of China (2009) China health statistical yearbook 2009. Peking Union Medical College Press, Beijing

  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

    Article  CAS  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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. 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. 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

    Article  PubMed  Google Scholar 

  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

    Article  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  10. Elam-Evans LD, Strauss LT, Herndon J, Parker WY, Whitehead S, Berg CJ (2002) Abortion surveillance—United States, 1999. MMWR Surveill Summ 51:1–28

    PubMed  Google Scholar 

  11. Statistics Canada, Therapeutic Abortion Survey (2003) Canadian Institute for Health Information (custom tabulation). Statistics Canada, Ottawa

  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

    Article  CAS  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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 27:642–646

    Article  PubMed  CAS  Google Scholar 

  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 54:95–108

    PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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

    Article  PubMed  CAS  Google Scholar 

  18. Virk J, Zhang J, Olsen J (2007) Medical abortion and the risk of subsequent adverse pregnancy outcomes. N Engl J Med 357:648–653

    Article  PubMed  CAS  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  21. Zhou W, Sørensen HT, Olsen J (1999) Induced abortion and subsequent pregnancy duration. Obstet Gynecol 94:948–953

    Article  PubMed  CAS  Google Scholar 

  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

    Article  PubMed  CAS  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  25. Allen RH, Westhoff C, De Nonno L, Fielding SL, Schaff EA (2001) Curettage after mifepristone-induced abortion: frequency, timing, and indications. Obstet Gynecol 98:101–106

    Article  PubMed  CAS  Google Scholar 

  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 59:153–159

    Article  PubMed  CAS  Google Scholar 

  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

    Article  PubMed  Google Scholar 

  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 16:679–682

    Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge the help from West China Second University Hospital, Sichuan provincial hospital for women and children, Chenghua and Longquanyi maternity and infant health institutes, and Chengdu No. 1 and No. 9 general hospitals. We also gratefully acknowledge all the research team members contributed to this study.

Conflict of interest

The authors have no conflicts of interest. There is no financial relationship with the organization that sponsored the research. We have had full control of all primary data and that we agree to allow the journal to review our data if requested.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Weiyue Zeng.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liao, H., Wei, Q., Duan, L. et al. Repeated medical abortions and the risk of preterm birth in the subsequent pregnancy. Arch Gynecol Obstet 284, 579–586 (2011). https://doi.org/10.1007/s00404-010-1723-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-010-1723-7

Keywords

Navigation