Studies - PreTerm Delivery / Premature Birth / Prematurity Complications

Pre-term Delivery Increases After Abortion, French Study (BJOG,4/05)

Women with Abortion History Are at Increased Risk of Delivering Very Preterm Babies in Subsequent Pregnancies — [study published in 4/05 issue, British Journal of Obstetrics and Gynaecology, Reuters Health]. Abstract: 

Previous induced abortions and the risk of very preterm delivery: results of the EPIPAGE study.  BJOG. 2005 Apr;112(4):430-7. 
Moreau C, Kaminski M, Ancel PY, Bouyer J, Escande B, Thiriez G, Boulot P, Fresson J, Arnaud C, Subtil D, Marpeau L, Roze JC, Maillard F, Larroque B; EPIPAGE Group.

Epidemiological Research Unit on Perinatal and Women’s Health, INSERM U149, Villejuif, France.
 
OBJECTIVES: To evaluate the risk of very preterm birth (22-32 weeks of gestation) associated with previous induced abortion according to the complications leading to very preterm delivery in singletons.
DESIGN: Multicentre, case-control study (the French EPIPAGE study).
SETTING: Regionally defined population of births in France.
SAMPLE: The sample consisted of 1943 very preterm live-born singletons (< 33 weeks of gestation), 276 moderate preterm live-born singletons (33-34 weeks) and 618 unmatched full-term controls (39-40 weeks).
METHODS: Data from the EPIPAGE study were analysed using polytomous logistic regression models to control for social and demographic characteristics, lifestyle habits during pregnancy and obstetric history. The main mechanisms of preterm delivery were classified as gestational hypertension, antepartum haemorrhage, fetal growth restriction, premature rupture of membranes, idiopathic preterm labor and other causes.
MAIN OUTCOME MEASURES: Odds ratios for very preterm birth by gestational age and by pregnancy complications leading to preterm delivery associated with a history of induced abortion. RESULTS: Women with a history of induced abortion were at higher risk of very preterm delivery than those with no such history (OR + 1.5, 95% CI 1.1-2.0); the risk was even higher for extremely preterm deliveries (< 28 weeks). The association between previous induced abortion and very preterm delivery varied according to the main complications leading to very preterm delivery. A history of induced abortion was associated with an increased risk of premature rupture of the membranes, antepartum haemorrhage (not in association with hypertension) and idiopathic spontaneous preterm labour that occur at very small gestational ages (< 28 weeks). Conversely, no association was found between induced abortion and very preterm delivery due to hypertension.

CONCLUSION: Previous induced abortion was associated with an increased risk of very preterm delivery. The strength of the association increased with decreasing gestational age.
PMID: 15777440 [PubMed – indexed for MEDLINE]

Report on the Study:

Dr. Caroline Moreau et al [Epidemiological Research Unit, Perinatal/Women’s Health, Hopital de Bicetre, France] examined records for 1,943 very preterm infants born before 33 weeks gestation, 276 moderately preterm infants born 33-34 weeks gestation, and 618 full-term infants born 39-40 weeks gestation.

Dr. Caroline Moreau et al concluded that women with a history of abortion were 1.5 times more likely to give birth very prematurely (under 33 weeks gestation), and 1.7 times more likely to have a baby born extremely preterm (under 28 weeks gestation). Their findings were reported in the April issue of the British Journal of Obstetrics and Gynaecology, a peer-reviewed medical journal.

Women who reported having had at least one induced abortion had a 50% higher risk of having a very preterm delivery than women who had never had an abortion. In addition, women who reported having previous abortions had a 70% higher risk of delivering an infant before 28 weeks gestation, compared with women who had never had an abortion.

Abortion increases a woman’s risk of delivering future children prematurely; the risk of very preterm delivery (less than 33 weeks) increases even more dramatically.

The researchers said that previous abortion was associated with an increased risk of very preterm delivery because of premature rupture of the membranes, unexplained spontaneous preterm labor and bleeding  not associated with maternal hypertension (high blood pressure) [Reuters Health].

Researchers found no association between previous abortion and very preterm delivery because of maternal hypertension.

Conclusion: induced abortion “increases the risk of preterm births, particularly extremely preterm deliveries;” more research is needed “to assess the differences in the level of risk according to the technique used for abortion”.

Preterm and very preterm births have been linked to health and developmental problems in infants, including cerebral palsy. 

Previous research, also conducted in Paris, revealed that the odds of a woman delivering prematurely increase with the number of abortions in her history, with the likelihood doubled in women who have had two or more abortions. Other research corroborated these findings, reporting that “the risk of preterm birth increased with the number of abortions,” according to a 2004 study.

Reduce Preterm Risk Coalition researcher Brent Rooney and Dr. Byron Calhoun revealed in 2003 that, in women with a history of four or more abortions, the risk of a future extremely early premature birth (less than 28 weeks gestation) is increased by eight times.  In addition, Rooney relates German research that revealed that a history of two abortions caused a five-fold increase in tendency to very premature babies, while three or more abortions increased the incidence to eight times the norm.  This massive 1998 study followed women in the German state of Bavaria.

Using data from a 1998 study of German women, Rooney contends that 35 percent of early preemies are in excess of what the total would be if no women had prior elective abortions. All this math means about 27,608 additional babies are born ‘early pre-term’ yearly to U.S. women, based on the estimate that 11 percent of U.S. women have had one abortion, and nine percent have had two or more abortions.

Of these 27,608 pre-term babies, roughly four percent will be born with cerebral palsy, Rooney argues. This translates to an extra 1,100 cases of children born with cerebral palsy in the U.S. annually.

Pre-term pregnancies contribute to a host of problems, including an increased risk of infant death, and as mentioned above, a significant increase in the tendency for the baby to develop cerebral palsy.

Rooney cites statistics indicating, “The cerebral palsy risk in extremely early premature birth babies is about 38 times higher than in the overall population of newborns.”

Rooney warns that the vast bulk of American women are never warned about the higher future risk of premature deliveries resulting from prior induced abortions. The only state Rooney is aware of that gives full informed consent by warning women of this danger is Texas.

See the Texas Department of Health’s Women’s Right to Know booklet at: http://www.tdh.state.tx.us/wrtk
Read a full PDF version of the above including references at: http://www.jpands.org/vol8no2/rooney.pdf
[from 1,100 Excess Brain Damaged Babies are Born Yearly in US Due to Previous Abortions
http://www.lifesite.net/ldn/2004/apr/04042209.html]

See related articles:
Abortion Linked to first
Increase in US Infant Mortality in 44 Years
http://www.lifesite.net/ldn/2005/jan/05012606.html
Read a full PDF version of Rooney’s paper cited above including references at: http://www.jpands.org/vol8no2/rooney.pdf
[PARIS, 29April2005 LifeSiteNews.com]

[Comment: Those of us who are older remember that when abortion was illegal, it was said that abortion could cause problems with later pregnancies. That common wisdom was thrown out the window when abortion was legalized. This is why studies like this are so important to get out the truth that abortion hurts both babies and women. N Valko RN.; Reuters Health, Douglas, KAISER DAILY REPRODUCTIVE HEALTH REPORT (not prolife) 4/29/05, item #6; http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=29698; Reuters Health, 4/27]