Studies - PreTerm Delivery / Premature Birth / Prematurity Complications

Induced Abortion and Premature Birth (Bibliography 1973-2000)

INDUCED ABORTION AND PREMATURE BIRTH, especially extreme (22-28 wk) premature birth. 

"ACOG continues to deny there is credible literature validating this association (see 06 Compendium, see ACOG Brief on the Ayotte Supreme Court Case). 

"And the March of Dimes, in their major initiative to find the causes of the preterm birth 'epidemic', fails to even mention the word 'abortion' in their poignant radio ads on the topic, or on their website entries discussing this major problem.

"As a refresher, remember that the Australian data base of 250,000 births showed a 60% increase in extreme premature birth after one abortion (mostly suction curettage), and a 150% increase after 2 abortions, 460% increase after 3 abortions, and 800% increase after 4 or more abortions

"Over 50 studies show such an association, with "dose relationship." 
One would think ACOG and MOD would suggest looking into the association. 

"Since the Australians and Europeans have, in fact, looked into it, and come up with a strong association, we can legitimately ask whether extreme prematurity (22-28 wk) is a problem worth our attention (and worth an informed consent discussion with the patient.)

"The following is taken from a letter by Brent Rooney, Canadian medical literature researcher, found in European Journal of Obstetrics & Gynecology and Reproductive Biology 2001;96:239-240:

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

"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)

"There are at least seventeen (17) (Ed. Note: that was in 2001. Now over 50) 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.

AAPLOG note:  "With the marked increase in extreme preterm birth (VLBW), which in itself gives rise to a marked increase in Cerebral Palsy, one would think the American medical minds would be interested in exploring this problem.  Privacy issues can be easily circumvented by encoding SS numbers.  But in the American system, we don't even have a data base for most abortions, as they are done in free standing clinics, for cash, and there is essentially no long term follow-up.  What an enlightened system-based on premeditated blindness and political correctness-and called, by the establishment, 'reproductive health

FYI: following are references for Brent Rooney's letter in the European journal:
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
3 Ericson A, Kallen B. Very low birthweight boys
   at 19. Arch Dis Child Fetal Neonatal Ed  1998;78
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 followin

   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
   Birthweight. Preventive Medicine 1992;21:98-109
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:
14 Lang JM, Lieberman E, Cohen A.  A  Comparison
   of Risk Factors for Preterm Labor and Term
   Small-for-Gestational-Age Birth. Epidemiology
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
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
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
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
[May 26, 2006, AAPLOG]