Studies - PreTerm Delivery / Premature Birth / Prematurity Complications

Abortion & Increased Premature Birth: Care for Women with Prior Preterm Birth (AJOG, 8/2010)

Medical Journal Confirms Abortion Associated With Increased Premature Birth

A new report in a prestigious medical journal confirms what previous studies have shown: abortion is associated with an increased risk of premature birth in subsequent pregnancies. Although the link is well-established, women are not normally informed of the risk when they are counseled at abortion centers.

Dr. Jay Iams a professor and vice chairman of the Department of Obstetrics and Gynecology at Ohio State University wrote a report on caring for women prior to pre-term birth in the American Journal of Obstetrics and Gynecology.

Iams writes, "Contrary to common belief, population-based studies have found that elective pregnancy terminations in the first and second trimesters are associated with a very small but apparently real increase in the risk of subsequent spontaneous pre-term birth."


As nurse Jill Stanek notes on her blog, the American Association of Pro-Life Obstetricians and Gynecologists noted the article and responded to it.

"We applaud his statement. Most high profile American writers won't breathe such a thing," the organization for pro-life OBGYN doctors said.

"There are currently 114 studies in the literature all showing a statistically significant association between induced abortion and subsequent pre-term birth. And just about none to the contrary," AAPLOG said.

It added that Dr. Iams writes "contrary to common belief" because "the association is systematically ignored or severely downplayed by the established authorities in our country. It is not mentioned under complications of induced abortion in any ACOG literature we know of. It is not generally taught. It is denied by default."

AAPLOG says Iams, in his notes, references the 2009 BJOG Shaw article, which found a 1.36 RR (36% increase) for pre-term birth with a previous induced abortion and it takes issue with Iams calling that increase "very small."

"Additionally, 50% of women have more than one abortion, and the literature finds the pre-term birth risk ratio for them goes to 1.6 to 1.9; that is, a 60% to 90% increase in pre-term birth in subsequent pregnancies," the organization added.

In fact, a study by researchers Shah and Zoe showed a 36% increased risk for pre-term birth after one abortion and a staggering 93% increased risk after two.

Similarly, the risk of subsequent children being born with low birth weight increases by 35% after one and 72% after two or more abortions. Another study shows the risk increases 9 times after a woman has had three abortions.

In his abstract, Iams writes: “African American women have rates of recurrent pre-term birth that are nearly twice that of women of other backgrounds" but offers no explanation why.

AAPLOG does: "African-American women have an induced abortion rate 3 times that of other American women. Might that factor in to the 2 times increased rate of pre-term birth?"

The medical group says the abortion-premature birth link is not only very real but has real consequences.

"Prematurity carries certain severe risks. Preemies under 32 weeks have a Cerebral Palsy rates 55 times higher that the rates for a term baby. Ignoring the 114 studies mentioned above (the “blind eye” approach) may not be in the best interest of women considering an induced abortion or of their subsequent children – wouldn't you say?" the group writes.

Pre-term birth is the leading cause of infant mortality in the industrialized world after congenital anomalies. Pre-term infants have a greater risk of suffering from chronic lung disease, sensory deficits, cerebral palsy, cognitive impairments, and behavioral problems. Low birth weight is similarly associated with neonatal mortality and morbidity.

Stanek, meanwhile, points out that the March 2003 issue of Pregnancy magazine contains what she calls a "rare find" — one of the rare instances where the mainstream media notes the abortion-premature birth risk.

The magazine noted that women who have three or more abortions have one of 14 risk factors associated with premature birth.

"Note induced abortion was listed last of 14 causes of premature births, in just about a worst case scenario, but it was there," Stanek said.  [August 18, 2010, Washington, DC, http://www.lifenews.com/nat6644.html ]

Aug 17, 2010  AAPLOG

The August issue of AJOG has an extremely informative article on preterm birth, an issue that complicates I in 8 pregnancies in the U.S.A.

Because of associated morbidity and expense, preterm birth is of intense interest to the medical community. The major author is Jay D. Iams, MD, MFM, Professor and Vice Chair of OSU Dept of ObGyn. (Jay D. Iams, MD; Vincenzo Berghells, MD. Care for women with prior preterm birth. American Journal of Obstetrics & Gynecology. August 2010;203(3):89-100)
We certainly commend this article to your study.

An Iam's observation of particular interest is the following:

"Contrary to common belief, population-based
studies,[34-36] have found that elective pregnancy
terminations in the first and second trimesters are
associated with a very small but apparently real
increase in the risk of subsequent spontaneous
preterm birth (PTB).[37]"

We applaud his statement. Most high profile American writers won't breathe such a thing. Allow us to mention 2 points in regard to his observation.

1. "contrary to common belief…..' There are currently 114 studies in the literature all showing a statistically significant association between induced abortion and subsequent preterm birth. And just about none to the contrary. Why then would this association be "contrary to common belief??" Because the association is systematically ignored or severely downplayed by the established authorities in our country. It is not mentioned under complications of induced abortion in any ACOG literature we know of. It is not generally taught. It is denied by default. Maybe that is why it is "contrary to common belief……" Obviously 114 articles should carry some weight, even to the willfully blind.

2. "…terminations….are associated with a very small but apparently real increase in the risk of subsequent spontaneous preterm birth (PTB)." Here he references the 2009 BJOG Shaw article, which found a 1.36 RR (36% increase) for PTB with a previous induced abortion. He calls this a "very small" increase. Remember the WHI study of 2003 that showed a RR of 1.3 for breast cancer in HRT users. 1.3 RR was NOT considered "very small"—in fact, it turned the HRT world upside down, so significant was it deemed to be! But here 1.36 RR Is called "very small" —maybe because induced abortion is the associated culprit? ("See no evil" in induced abortion)

Additionally, 50% of women have more than one abortion, and the literature finds the PTB risk ratio for them goes to 1.6 to 1.9., that is a 60% to 90% increase in PTB is subsequent pregnancies

Finally, in the abstract, Dr. Iams notes:

"African American women have rates of recurrent preterm birth that are nearly twice that of women of other backgrounds." He hazards no guess as to why.

Africian-American women have an induced
abortion rate 3 times that of other American women. Might THAT factor in to the 2X increased rate of PTB?? Perish the thought!! Rather than consider the abortion association, some have even suggested it may be a racial genetic failing in the cervical tissues of African-Americans! ("see no evil")

Prematurity carries certain severe risks. Preemies under 32 weeks have a Cerebral Palsy rates 55 times higher that the rates for a term baby. Ignoring the 114 studies mentioned above (the "blind eye" approach) may not be in the best interest of women considering an induced abortion, or of their subsequent children—would you say??

PS: for a summary of the last 15 or so years literature on induced abortion and subsequent PTB, go to http://www.aaplog.org/complications-of-induced-abortion/induced-abortion-and-pre-term-birth/