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  • Title: The effect of induced abortion on subsequent pregnancy outcome.
    Author: Frank PI, McNamee R, Hannaford PC, Kay CR, Hirsch S.
    Journal: Br J Obstet Gynaecol; 1991 Oct; 98(10):1015-24. PubMed ID: 1751433.
    Abstract:
    OBJECTIVE: To investigate the effect of induced abortion on the outcome of the next pregnancy. DESIGN: Long-term prospective controlled cohort study. SETTING: Joint Royal College of General Practitioners/Royal College of Obstetricians and Gynaecologists study based in general practice in England, Scotland and Wales. SUBJECTS: 1311 women whose recruitment pregnancy had ended in induced abortion (the abortion group) and 2131 women whose recruitment pregnancy had a natural conclusion (the non-abortion group). MAIN OUTCOME MEASURES: Non-viable outcome (spontaneous or missed miscarriage, ectopic pregnancy or stillbirth), birthweight, length of gestation. RESULTS: Induced abortion was not materially associated with any of the three measures of adverse outcome. Compared with the non-abortion group the relative risk of a non-viable outcome in the abortion group was 1.01 (95% CI 0.81 to 1.27). In the abortion group birthweight was an average 23 g lighter (95% CI -76 g to + 30 g) and length of gestation an average 0.9 days shorter (95% CI -2.2 days to + 0.4 days) than in the non-abortion group. Women who had their abortions in NHS premises had an increased risk of a non-viable outcome (RR 2.55, 95% CI 1.31 to 4.94) and had babies with significantly lower mean birthweight (-119 g, 95% CI -233 g to +5 g) compared with those who obtained their operations in the private sector. Women whose abortion had been carried out by a consultant had the lowest risk of non-viable outcome. Although these differences remained after adjustment for a number of important variables, it is possible that factors not measured in the present study, such as economic status and occupation, played a contributory role. CONCLUSION: Overall, induced abortion was not associated with any important effect on the three measures of adverse outcome in the subsequent pregnancy. The authors investigated the effect of induced abortion on the outcome of the next pregnancy. This longterm, prospective, controlled cohort study was undertaken at the Joint Royal College of General Practitioners/Royal College of Obstetricians and Gynecologists and was based in general practice in England, Scotland, and Wales. 1311 women whose recruitment pregnancy had ended in induced abortion (abortion group) and 2131 women whose recruitment pregnancy ended naturally (nonabortion group) were included in this study. The main outcome measures investigated were nonviable outcome (spontaneous or missed miscarriage, ectopic pregnancy, or stillbirth), birthweight, and length of gestation. Induced abortion was not materially associated with any of the 3 measures of adverse outcome. Compared with the nonabortion group, the relative risk of a nonviable outcome in the abortion group was 1.01 (95% CI 0.81-1.27). In the abortion group, birthweight was an average 23 g lighter (95% CI -76g to +30 g) and the length of gestation was an average of 0.9 days shorter (95% CI -2.2 days to 0.4 days) than in the nonabortion group. Women who had their abortions in NHS premises had an increased risk of a nonviable outcome (RR 2.55, 95% CI 1.31-4.94) and had babies with significantly lower mean birthweight (-119 g, 95% CI -233 g to +5 g) compared with those who obtained their operations in the private sector. Women whose abortions had been undertaken by a consultant had the lowest risk of nonviable outcome. Although these differences remained after adjustment for a number of important variables, it is possible that factors not measured in the present study, e.g., economic status and occupation, played a contributory role. Overall, induced abortion was not associated with any important effect on the 3 measures of adverse outcome in a subsequent pregnancy.
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