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PubMed1996

Abortion and breast cancer risk.

The relationship between spontaneous and induced abortions and breast cancer risk was analyzed using data from a case-control study conducted between June 1991 and February 1994 in 6 Italian centers on 2,569 histologically confirmed incident breast cancer cases and 2,588 controls admitted to hospital for a wide range of acute, non-neoplastic, non-hormone-related diseases. One or more abortions were reported by 31% of cases and 32% of controls, corresponding to a multivariate odds ratio (OR) of 1.0 (95% confidence interval [CI], 0.8-1.1). No trend in risk was observed with increasing number of total abortions or spontaneous and induced abortions separately. No significant relationship was found between the risk of breast cancer and history of spontaneous or induced or total abortions in separate strata of age at diagnosis, number of children, time of abortion in relation to first birth and family history of breast cancer. When abortion was the outcome of the first pregnancy, the OR was 1.2 for spontaneous and 1.3 for induced abortion, in relation to women with birth as outcome of the first pregnancy, and 1.0 and 1.1, respectively, when the reference category was nulligravidae. Thus, our results indicate a lack of association between induced and spontaneous abortions and breast cancer risk.

Abortion, Induced↗
PubMed1991

Spontaneous and induced abortions and risk of breast cancer.

The relationship between spontaneous or induced abortion and the risk of breast cancer was analyzed in a case-control study conducted in the greater Milan area on 2,394 cases of breast cancer and 2,218 controls in hospital for a spectrum of acute conditions, not gynecological, hormonal or neoplastic. No consistent relationship emerged between spontaneous or induced abortion and breast cancer: compared with women reporting no abortions (spontaneous or induced), the multivariate relative risk (RR) was 1.0 (95% confidence interval, CI, 0.9 to 1.2) in those reporting one abortion and 0.9 (95% CI 0.7 to 1.0) in those reporting two or more. This lack of association was consistent in strata of age and parity, including younger women. We further analyzed the risk of breast cancer associated with an abortion before and after full-term pregnancy. Compared with parous women reporting no induced or spontaneous abortions, those who had an abortion before their first full-term pregnancy had about a 20% higher risk of breast cancer. This finding, however, was not statistically significant (RR 1.2, 95% CI 0.9 to 1.7). No increased risk was observed in women who had had a first abortion after a full-term pregnancy (RR 0.9, 95% CI 0.8 to 1.0). This study does not support the hypothesis that spontaneous or induced abortion appreciably influences subsequent breast-cancer risk.

Abortion, Induced↗
PubMed1993

Long-term impact of reproductive factors on cancer risk.

The relationship between reproductive variables (parity, age at first birth, number of induced and spontaneous abortions) and cancer risk has been analysed using data from an integrated series of case-control studies conducted in northern Italy between 1983 and 1992. The overall data-set included women below age 75 with histologically confirmed cancers of the following sites: oesophagus, 58; stomach, 280; colon, 405; rectum, 210; liver, 82; gall-bladder, 29; pancreas, 129; breast, 3,415; cervix, 742; endometrium, 725; ovary, 953; bladder, 68; kidney, 56; thyroid, 180; lymphomas, 80; myelomas, 57; and a total of 5,619 controls admitted to hospital for acute non-neoplastic, non-gynaecological, non-hormone-related conditions. Multivariate odds ratios, as estimators of relative risks (RR), were obtained after allowance for age, education, use of oral contraceptives and oestrogen replacement treatments, plus various reproductive factors. Direct significant trends with parity were observed for cancer of the liver (RR for women with > or = 4 births vs. nulliparae = 3.3) and cervix uteri (RR = 4.1). The risk of gall-bladder cancer was also elevated for multiparae (RR = 1.9). No significant inverse trend in risk emerged. However, the RRs in multiparae were significantly below unity for breast (RR = 0.8), endometrium (RR = 0.7), and ovary (RR = 0.8). With reference to age at first birth, a significant trend in risk was observed for breast cancer (RR = 1.4 for 25 to 29 and 1.5 for > or = 30 vs. < 25 years). In contrast, the risk of cervical cancer was inversely related to age at first birth. For spontaneous abortions, the only significant inverse trend was for ovarian cancer (RR = 0.7 for > or = 2 vs. 0 abortions), but also the point estimate for endometrial cancer in women with > or = 2 abortions was below unity. For induced abortions, there was a strong inverse trend in risk for endometrial cancer (RR = 0.5), and the RRs were below unity also for colon and breast cancer. In contrast, cervical cancer was directly associated with the number of spontaneous abortions. Although the underlying aetiological interpretations are different for various cancer sites, this study provides, in a large and uniform data-set, quantitative information on the long-term impact of reproductive factors on cancer risk.

Abortion, Induced↗
PubMed1995

Abortion and the risk of breast cancer: a case-control study in Greece.

We have examined the association between induced or spontaneous abortion and breast cancer risk in Greece. In a hospital-based case-control study in Athens, 820 patients with confirmed breast cancer were compared with 795 orthopedic patient controls and 753 healthy visitor controls, matched to cases by age and interviewer. Logistic regression was used to analyze the data, controlling for demographic, reproductive and nutritional variables. Odds ratio (OR) patterns were similar for the 2 control series, which were therefore combined to increase precision of the estimates. The risk for breast cancer was not increased for women who had a history of abortion, compared to nulliparous women with no history of abortion. Thus ORs and 95% confidence intervals were for nulliparous women with spontaneous abortion, 1.17 (0.64-2.13); for nulliparous women with induced abortion, 0.98 (0.56-1.73); for parous women with no abortion, 0.56 (0.31-1.01); for parous women with spontaneous abortion, 0.61 (0.33-1.14) and for parous women with induced abortion, 0.99 (0.56-1.74). When the analysis was restricted to parous women, using parous women with no history of abortion as the baseline, ORs and 95% confidence intervals were for induced abortion before first full-term pregnancy, 2.06 (1.45-2.90); for induced abortion after first full-term pregnancy, 1.59 (1.24-2.04) and for spontaneous abortion, 1.10 (0.82-1.40). Our findings suggest that an interrupted pregnancy does not impart the long-term protective effect of a full-term pregnancy attributable to terminal differentiation.

Abortion, Induced↗
PubMed1991

The impact of supportive intervention after second trimester termination of pregnancy for fetal abnormality.

The reactions of women who had had a termination of pregnancy for fetal abnormality in the second trimester have been studied retrospectively using a semi-structured questionnaire. The severity of the grief reaction was measured and the outcome at 6 months was compared with the findings from a previous study in South Wales which had led to the introduction of skilled support from genetic fieldworkers and formal genetic counselling after the termination. Of the 69 women interviewed, 55 (80 per cent) experienced an acute grief reaction and 17 (25 per cent) had not resolved their grief 6 months after the termination, compared with 37 (77 per cent) and 22 (46 per cent) out of 48 respectively in the previous study. Fifty-seven (83 per cent) women had found the fieldworker's intervention useful or very useful, some describing her support as essential. An association between poor resolution of the grief reaction with increasing maternal age and with poor perceived support from partners was noted. Improved follow-up support and counselling have lessened the adverse emotional consequences and support should therefore be offered to all women undergoing termination for fetal malformation.

Abortion, Therapeutic↗
PubMed1992

Reproductive behaviour and prenatal diagnosis following genetic termination of pregnancy in women of advanced maternal age.

One hundred and fifty-one women of advanced maternal age who underwent genetic termination of pregnancy (TOP) were studied for their reproductive behaviour and the type of procedure for prenatal diagnosis in a subsequent pregnancy. A total of 59 women (39 per cent) had a further pregnancy. In all continuing pregnancies prenatal diagnosis was performed, of which 75 per cent consisted of chorionic villus sampling (CVS). Reproductive behaviour following a genetic termination was negatively correlated with maternal age and parity. Both reproductive behaviour and the choice to undergo a diagnostic procedure in the next pregnancy were independent of the type of diagnostic procedure in the previous affected pregnancy.

Abortion, Therapeutic↗
PubMed1995

An economic analysis of pregnancy resolution in Virginia: specific as to race and residence.

This study analyses an economic model of pregnancy resolution; that is, a model of the choice by a pregnant woman to abort her fetus or carry it to term. This analysis, using an analytical model derived from the household utility framework, adds to previous research by presenting race- and residence-specific estimates of how individual characteristics, history of abortion, and the community-based factors determine women's choices of giving birth vs. aborting. The main data for estimating the model were drawn from the 1984 vital statistics of all induced abortions and live births in the Commonwealth of Virginia. The major findings indicate that low parental education, high maternal age, previous early abortions, and the availability of abortion providers all significantly reduce the probability of choosing the live birth option. Married status and the availability of family planning clinics significantly increase the probability of the live birth option. The findings also suggest that women's choices between abortion and live birth vary substantially with race (White vs. Black) and residential (urban vs. rural) location.

Abortion, Induced↗
PubMedDate not supplied

Induced abortion: microbiological screening and medical complications.

Preoperative cervical screening of 1,193 women undergoing first-trimester induced abortions yielded Chlamydia trachomatis in 11.7%, Neisseria gonorrhoeae in 0.8%, Mycoplasma hominis in 22.1%, Ureaplasma urealyticum in 10.1%, herpes simplex virus in 0.9% and Group B streptococci (GBS) in 2.9%. C. trachomatis and N. gonorrhoeae were especially frequent among teenagers. A total of 2.2% (26 women) developed postoperative pelvic inflammatory disease (PID) and 0.9% (13 women) endometritis. PID developed significantly more often in untreated chlamydia-positive (22.7%), M. hominis-positive (8.1%) and GBS-positive (6.1%) women than in women without these microbes (0.5%) (p less than 0.05). Prompt treatment of the chlamydia infection before or in connection with the abortion procedure significantly decreased the likelihood of developing chlamydial PID from 22.7% to 2.1% (p less than 0.001). The study confirms the importance of preoperative screening for chlamydia and suggests screening for M. hominis and GBS as well. The results of screening should be available before the abortion, allowing patients to be treated pre- or peroperatively.

Abortion, Induced↗
PubMed1981

A new prostaglandin E2-gel for pretreatment of the cervix in nulliparous patients having a late first trimester termination of pregnancy.

A new PGE2-gel, based on a cross-linked starch powder, has been developed. This gel seems to have solved several of the pharmaceutical and practical problems connected with local administration of prostaglandins. In a three-center study 120 nulliparous patients were given 0.5 mg PGE2 in 2.2 ml gel intracervically prior to dilatation of the cervix and evacuation of the uterus in late first trimester. Considerable cervical dilatation was obtained within 15 h. The frequency of side effects, including pain and gastro-intestinal discomfort was low. The technique can be recommended for outpatients.

Abortion, Induced↗
PubMed1983

Sulprostone for preoperative cervical dilatation in primigravidae scheduled for late first trimester termination of pregnancy.

The cervix was primed with intracervical (intramural), i.m. or s.c. injections of Sulprostone in varying doses at various times before termination of late first trimester pregnancy in 170 primigravidae. Intracervical administration of Sulprostone (25-100 micrograms) 14-16 h before surgery required the lowest dosage and had no side effects. However, the highest dose of Sulprostone (100 micrograms) achieved a cervical dilatation to Hegar 7 or more in only 40% of patients. A cervical dilatation of Hegar 7 or more was achieved in 90% of the cases when 350 micrograms of Sulprostone was given i.m. 3-4 h preoperatively.

Abortion, Induced↗
PubMed1975

Extraovular prostaglandin F2alpha for early midtrimester abortion.

Twenty patients who were 13 to 15 weeks pregnant received extraovular prostaglandin F2-alpha (PGF2a) in dosages of 3 mg. every 1 to 3 hours. Ninety-five per cent of the patients successfully aborted and 30 per cent of the patients had retained placental tissue. The mean abortion time was 17 3/4 hours and the average total dose used was 29.2 mg. The abortion time appeared to decrease with parity and had no relationship to weeks of gestation. Only one patient failed to abort after 31 hours of therapy. She required a curettage and was the only patient to develop a postabortion infection. The technique appears to compare favorably with the results of intra-amniotic PGF2a. Extraovular prostaglandin may therefore be of particular value in inducing abortion in patients who are in the early midtrimester of pregnancy, i.e., when intra-amniotic instillation is technically infeasible.

Abortion, Induced↗