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  • Title: Induced abortion as a risk factor for subsequent fetal loss.
    Author: Infante-Rivard C, Gauthier R.
    Journal: Epidemiology; 1996 Sep; 7(5):540-2. PubMed ID: 8862989.
    Abstract:
    The relation between past induced abortions and subsequent fetal loss is still unclear. We report a case-control study with 331 cases of first spontaneous abortion and 993 controls with no previous spontaneous abortion and a normal pregnancy at the same period of pregnancy. In comparison with primigravid women, the odds ratio for a fetal loss in the current one was 1.41 [95% confidence interval (CI) = 0.81-2.43] among women with one previous pregnancy ending in induced abortion, 4.43 (95% CI = 1.46-13.36) among those with two previous induced abortions out of two pregnancies, and 1.35 (95% CI = 0.64-2.82) among women with three or more previous pregnancies ending in one or more induced abortions. During May 1987-November 1989 in Montreal, Quebec, both 331 cases of first spontaneous abortion and 993 controls with a normal pregnancy and no previous spontaneous abortion at the time of the study were enrolled in a case control study to examine the relationship between past induced abortions and subsequent spontaneous abortion. 90 (20.2%) cases and 240 (18.1%) controls had had at least one previous induced abortion. When comparing women who had had a previous pregnancy with primigravidae, women whose 1 previous pregnancy ended in induced abortion, those whose 2 previous pregnancies ended in induced abortion, and those who had at least 1 induced abortion in their 3 or more previous pregnancies faced an increased risk of spontaneous abortion (odds ratio [OR] = 1.41, 4.43, and 1.35, respectively). The researchers found the same risk when they adjusted for vaginal infection. Second trimester abortions were associated with an increased risk of first spontaneous abortion (OR = 4.63). Women whose last induced abortion occurred 12-24 months before the current pregnancy with no pregnancy in between the induced abortion and the current pregnancy faced an increased risk of spontaneous abortion (OR = 2.28). There was no increased risk of spontaneous abortion when the induced abortion occurred at least 24 months before with no pregnancy in between the induced abortion and current pregnancy, suggesting that the uterus requires time to recover before successful future implantation.
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