Studies - PreTerm Delivery / Premature Birth / Prematurity Complications

Abortion, Preterm Birth & Cerebral Palsy Link (Letter EJOGRB, 2001, 1999), Bibliography

European Medical Journal exposes Abortion-Cerebral-Palsy:
Elective Surgery boosts Cerebral Palsy risk

In their excellent review of CP (Cerebral Palsy) history, Schifrin and Longo
end with the words, "We need to let the truth take us where it will."(1)

This letter assumes that there is the courage to do exactly that.

Although the etiology of CP has many uncertainties, preterm birth and
incompetent cervix are considered to be risk factors
.(2)

A preterm new-born is much more likely to be Very Low Birth Weight (VLBW: birth weight under 1500 grams) than a full-term newborn.

A Swedish study of 19 year-old boys reported fifty-five times the normal risk of CP for boys with VLBW (95% CI 40.8-75.2).(3)  From a 1991 CP-VLBW meta-analysis: "If one assumes the incidence of cerebral palsy in the general population to be 2/1000 live births …. then the relative risk for cerebral palsy among surviving VLBW infants would be 38 times that in the general population."(4)

Elective Surgery and Preterm Birth risk

There are at least seventeen studies that have found that previous
induced abortions increase preterm birth risk.(8-24)

 The latest of these studies reported on 61,000 Danish women and is one 
of the largest studies ever linking "terminations" to later prematurity.(9) 
The relative risk of a very preterm birth (before 34 weeks' gestation)
for Danish women with one previous induced abortion is 1.99. 
The relative risk of a pre-term birth for women with two previous
"evacuation" type abortions is 12.55.(5) The RR for one previous
"evacuation" abortion is 2.27.(5)
   
 Why the silence about the abortion-prematurity risk and cerebral palsy                    

 from medical researchers?  

 

Let's have the courage to explore this credible risk with the definite possibility that

what is learned may help reduce the cerebral palsy rate

and the heartache that it causes the affected infants and parents.

 

Is it biologically plausible that abortions can increase risk

of a subsequent preterm birth?

 

Highly regarded obstetric expert, Barbara Luke (PhD), has identified one
mechanism that explains abortion causing prematurity risk. "The procedures
for first-trimester abortion involve dilating the cervix slightly and
suctioning the contents of the uterus (see Figure 3).The procedures for
second-trimester abortion are more involved, including dilating the cervix
wider and for longer periods, and scraping the inside of the uterus. Women
who had had several second-trimester abortions may have a higher incidence
of incompetent cervix, a premature spontaneous dilation of the cervix,
because the cervix has been artificially dilated several times before this
pregnancy." (5) 

 

The second biological risk that helps to explain higher prematurity is

infection risk.

 

"Our findings indicate that an abortion in a woman's first pregnancy does not have the same protective effect of lowering the risk for intrapartum infection in the following pregnancy as does a live birth." 

So wrote researchers from the University of Washington in the journal Epidemiology in 1996.(6) Infection is a leading cause of death from
induced abortion (if one ignores breast cancer and suicide from abortion ).

Infection is often mentioned as a risk factor for premature birth.  In 1992
Dr. Janet Daling and colleagues reported that if the previous pregnancy
ended in induced abortion, the risk of intra-amniotic infection increased by
140%.(7) "One possible mechanism is that cervical instrumentation can
facilitate the passage of organisms into the upper part of the uterus,
increasing the probability of inapparent infection and subsequent preterm
birth", wrote Judith Lumley in 1998.8

 

Informed Medical Consent is a must

 

Over the past two decades the rate of Cerebral Palsy has been increasing in
the United States and other developed countries.  If there is an elective
medical procedure that increases prematurity risk, then potential patients
of that procedure must be made aware of subsequent preterm birth risk and
the associated Cerebral Palsy risk. 

 

Since it is conceded by abortion practitioners that induced abortion is normally

an elective procedure, full information about serious possible risks must appear 

on consent forms.

 

Informed medical consent is a legal right of all women.  Let's stop denying
them this right at abortion clinics. "We need to let the truth take us where
it will."(1)
Brent Rooney,
Reduce Preterm Risk Coalition
3456 Dunbar St. (146)
Vancouver, Canada  V6S 2C2
[Letter:  European Journal of Obstetrics & Gynecology and Reproductive Biology

2001;96:239-240]
[email protected]
References
 1 Schifrin BS, Longo LD. William  John   Little and
   cerebral palsy    A reappraisal.  European J
   Obstetrics & Gynecology 2000;90:139-144
 
 2 Gersh ES.  Children with Cerebral Palsy: a parent's
   guide / edited by Elaine Geralis. 1998; chapter 1:
   page 14 [Bethesda, Maryland: Woodbine House; ISBN
   0933149824]

 3 Ericson A, Kallen B. Very low birthweight boys
   at 19. Arch Dis Child Fetal Neonatal Ed  1998;78
   :F171-F174

 4 Escobar GJ, Littenberg B, Petitti DB.  Outcome
   among surviving very low birthweight infants; a
   meta-analysis. Arch Dis Child 1991;66:204-211

 5 Luke B, Every Pregnant Woman's Guide to
   Preventing Premature Birth (1995, pp. 32-33)

 6 Muhlemann K, Germain M, Krohn M. Does an
   Abortion Increase the Risk of Intrapartum
   Infection in the Following Pregnancy? Epidem-
   iology 1996;7:194-198

 7 Daling JR, Krohn MA, Miscarriage or Termination
   in the Immediately Preceding Pregnancy
   Increases the Risk of Intraamniotic Infection
   in the Following  Pregnancy.  American J Epi
   1992;136:1013 [SER Abstracts]

 8 Lumley J. The association between prior spon-
   taneous abortion, prior induced abortion and
   preterm birth in first singleton births.
   Prenat Neonat Med 1998;3:21-24.

 9 Zhou W, Sorenson HT, Olsen H. Induced Abortion
   and Subsequent Pregnancy Duration. Obstetrics &
   Gynecology 1999;94:948-953

10 Pickering RM, Forbes J. Risk of preterm delivery
   and small-for-gestational age infants following
   abortion: a population study. British J Obstet-
   rics and Gynecology 1985;92:1106-1112
 
11 Michielutte R, Ernest JM, Moore ML, Meis PJ,
   Sharp PC, Wells HB, Buescher PA. A Comparison of
   Risk Assessment Models for Term and Preterm Low
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12 Berkowitz GS. An Epidemiologic Study of Preterm
   Delivery. American J Epidemiology 1981;113:81-92

13 Lieberman E, Ryan KJ, Monson RR, Schoenbaum SC.
   Risk Factors Accounting For Racial Differences
   in the rate of premature birth. NEJM 1987;317:
   743-748

14 Lang JM, Lieberman E, Cohen A.  A  Comparison
   of Risk Factors for Preterm Labor and Term
   Small-for-Gestational-Age Birth. Epidemiology 
   1996;7:369-376

15 Mueller-Heubach E, Guzick DS. Evaluation of
   risk scoring in a preterm birth prevention
   study of indigent patients. Am J Obstetrics
   & Gyn  1989;160:829-837

16 Shiono PH, Lebanoff MA.  Ethnic  Differences 
   and  Very Preterm Delivery. Am J Public Health 
   1986;76:1317-1321

17 Pantelakis SN, Papadimitriou GC, Doxiadis SA.
   Influence of induced and spontaneous abortions
   on the outcome of subsequent pregnancies. Amer
   J Obstet Gynecol. 1973;116:799-805

18 Van Der Slikke JW, Treffers PE. Influence of
   induced abortion on gestational  duration in
   subsequent pregnancies. BMJ 1978;1:270-272

19 Richardson JA, Dixon G. Effect of legal termin-
   ation on subsequent pregnancy. British Med J
   1976;1:1303-1304

20 Pickering RM, Deeks JJ. Risks of Delivery during
   20th to the 36th Week of Gestation. Intl. J
   Epidemiology 1991;20:456-466

21 Koller O, Eikhom SN. Late Sequelae of Induced
   Abortion in Primigravidae. Acta Obstet Gynecol
   Scand 1977;56:311-317

22 Papaevangelou G, Vrettos AS, Papadatos D, Alexiou
   C. The Effect of Spontaneous and Induced Abortion
   on Prematurity and Birthweight. The J Obstetrics
   and Gynaecology of the British Commonwealth. May
   1973;80:418-422

23 Bognar Z, Czeizel A.  Mortality  and  Morbidity 
   Associated with Legal Abortions in Hungary, 1960-
   1973. AJPH 1976;66:568-575

24 Martius JA, Steck T, Oehler MK, Wulf K-H. Risk
   factors associated with preterm (<37+0 weeks) and
   early preterm (<32+0 weeks): univariate and multi-
   variate analysis of 106 345 singleton births from
   1994 statewide perinatal survey of Bavaira.
   European J Obstetrics & Gynecology Reproductive
   Biology 1998;80:183-189