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Previous Volume 357:648-653 August 16, 2007 Number 7 Next

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ABSTRACT

Background The long-term safety of surgical abortion in the first trimester is well established. Despite the increasing use of medical abortion (abortion by means of medication), limited information is available regarding the effects of this procedure on subsequent pregnancies.

Methods We identified all women living in Denmark who had undergone an abortion for nonmedical reasons between 1999 and 2004 and obtained information regarding subsequent pregnancies from national registries. Risks of ectopic pregnancy, spontaneous abortion, preterm birth (at <37 weeks of gestation), and low birth weight (<2500 g) in the first subsequent pregnancy in women who had had a first-trimester medical abortion were compared with risks in women who had had a first-trimester surgical abortion.

Results Among 11,814 pregnancies in women who had had a previous first-trimester medical abortion (2710 women) or surgical abortion (9104 women), there were 274 ectopic pregnancies (respective incidence rates, 2.4% and 2.3%), 1426 spontaneous abortions (12.2% and 12.7%), 552 preterm births (5.4% and 6.7%), and 478 births with low birth weight (4.0% and 5.1%). After adjustment for maternal age, interval between pregnancies, gestational age at abortion, parity, cohabitation status, and urban or nonurban residence, medical abortion was not associated with a significantly increased risk of ectopic pregnancy (relative risk, 1.04; 95% confidence interval [CI], 0.76 to 1.41), spontaneous abortion (relative risk, 0.87; 95% CI, 0.72 to 1.05), preterm birth (relative risk, 0.88; 95% CI, 0.66 to 1.18), or low birth weight (relative risk, 0.82; 95% CI, 0.61 to 1.11). Gestational age at medical abortion was not significantly associated with any of these adverse outcomes.

Conclusions We found no evidence that a previous medical abortion, as compared with a previous surgical abortion, increases the risk of spontaneous abortion, ectopic pregnancy, preterm birth, or low birth weight.

Source Information

From the Department of Epidemiology, University of California, Los Angeles (J.V., J.O.); the Epidemiology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD (J.Z.); and the Institute of Public Health, Aarhus University, Aarhus, Denmark (J.O.).

Address reprint requests to Dr. Zhang at the Epidemiology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bldg. 6100, Rm. 7B03, Bethesda, MD 20892, or at zhangj{at}mail.nih.gov.

Full Text of this Article

This article has been cited by other articles:

• Ljung, R., Danielsson, M., Lindam, A. (2009). MEDICATION ABORTION AS A QUALITY INDICATOR FOR REGIONAL COMPARISONS IN SWEDEN. AJPH 99: 197-198 [Full Text]  
• Zhu, Q.-X., Gao, E.-S., Chen, A.-M., Luo, L., Cheng, Y.-M., Yuan, W. (2009). Mifepristone-induced abortion and placental complications in subsequent pregnancy. Hum Reprod 24: 315-319 [Abstract] [Full Text]  
• (2007). Does Medical Abortion Compromise Subsequent Pregnancies?. JWatch Women's Health 2007: 5-5 [Full Text]  
• (2007). Subsequent Pregnancy Outcomes Are Similar After Medical and Surgical Abortion. JWatch General 2007: 1-1 [Full Text]