[Induced abortion--history, present status and perspectives].
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Abortion, Induced↗
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Abortion history and breast cancer risk: results from the Shanghai Breast Cancer Study.
Studies of the association between induced abortion and breast cancer risk have been inconsistent, perhaps due to underreporting of abortions. Induced abortion is a well-accepted family planning procedure in China, and women who have several induced abortions do not feel stigmatized. The authors used data from a population-based case-control study of breast cancer among women age 25-64 conducted between 1996 and 1998 in urban Shanghai to assess whether a history of and the number of induced abortions were related to breast cancer risk. In-person interviews were completed with 1,459 incident breast cancer cases ascertained through a population-based cancer registry, and 1,556 controls randomly selected from the general population in Shanghai (with respective response rates of 91% and 90%). After adjusting for confounding, there was no relation between ever having had an induced abortion and breast cancer (odds ratio [OR] = 0.9, 95% confidence interval [CI] 0.7-1.2). Women who had 3 or more induced abortions were not at increased risk of premenopausal breast cancer (OR = 0.9, 95% CI 0.6-1.4) or postmenopausal breast cancer (OR = 1.3, 95% CI 0.8-2.3). These results suggest that a history of several induced abortions has little influence on breast cancer risk in Chinese women.
Abortion, Induced↗
Abortion: history, opinions, and what's new in the United States.
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Abortion, Induced↗
Medical and psychological management of recurrent abortion, history of postneonatal death, ectopic pregnancy and infertility: successful implementation of IVF for multifactorial reproductive dysfunction. A case report.
The medical and psychological treatment for a 37-year-old Caucasian G6 P1051 woman who presented for evaluation of secondary infertility and recurrent pregnancy loss is described. Although one living child had been conceived without medical assistance, that delivery preceded the present evaluation by ten years and involved a different partner. With the current husband, the patient had two miscarriages and a left ectopic pregnancy. The couple had attempted controlled ovarian hyperstimulation and in vitro fertilization (IVF) elsewhere, but the cycle was cancelled due to poor follicular response. About one year before consultation at our institution, the couple established a pregnancy although the infant was born at 24 weeks with a cardiac anomaly, living only 40 days. Additionally, a persistent cervical lesion required cone biopsy before any fertility treatment could resume. Andrology evaluation found the husband's sperm DNA fragmentation index to be 48.6%. This constellation of stressors represented substantial emotional issues and psychological therapy/counseling was recommended. After obtaining psychological clearance, the couple underwent IVF and 16 oocytes were retrieved. Four embryos were transferred, and a healthy male infant was delivered at term. Although multifactorial infertility can be associated with very poor reproductive outcomes, the advanced reproductive technologies merit consideration during management of complex clinical challenges. Standard IVF strategies can be optimized by inclusion of thorough psychological assessment and counseling.
Abortion, Habitual↗
Abortion--legal history.
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Abortion, Legal↗
A history of induced abortion in relation to substance use during subsequent pregnancies carried to term.
OBJECTIVE: Previous research has revealed a general association between induced abortion and substance use. The purpose of this study was to examine the correlation when substance use is measured specifically during a subsequent pregnancy. STUDY DESIGN: A nationally representative sample of women was surveyed about substance use during pregnancy shortly after giving birth. Women with a previous induced abortion, whose second pregnancy was delivered, were compared separately with women with one previous birth and with women with no previous births. RESULTS: Compared with women who gave birth, women who had had an induced abortion were significantly more likely to use marijuana (odds ratio, 10.29; 95% CI, 3.47-30.56), various illicit drugs (odds ratio, 5.60; 95% CI, 2.39-13.10), and alcohol (odds ratio, 2.22; 95% CI, 1.31-3.76) during their next pregnancy. The results with only first-time mothers were very similar. CONCLUSION: Psychosocial mechanisms that may explain the findings are discussed. Screening for abortion history may help to identify pregnant women who are at risk for substance use more effectively.
Abortion, Induced↗
Abortion: a history.
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Abortion, Illegal↗
Risk factors of anemia among women in the child bearing period and preschool children in Alexandria.
This study was carried out to determine the risk of some social and biological maternal factors which may contribute to occurrence of anemia among mothers and preschool children. A community based comparative study was chosen for the conduction of this work. The target population were 400 women in the child bearing period, having at least one preschool child (440). Capillary blood samples were taken by finger prick method and hemoglobin level was estimated by Sahly method. According to the cut off level of hemoglobin, women were classified into anemic and non anemic. In addition to that, 440 preschool children belonging to these women were classified according to the cut off level of their hemoglobin into 165 anemic children and 275 non anemic ones. An interview questionnaire was used to collect the data. Analysis of results showed that age of mother (30 years and above), illiteracy, high parity, history of previous abortion, history of previous perinatal mortality, small inter-birth interval and non use of contraceptives are significant risk factors for mothers. However, mother occupation and state of pregnancy has no role in occurrence of anemia among mothers. In addition to that, high parity, history of previous abortion, history of perinatal mortality, short inter-birth interval, non use of contraceptives and pregnancy are maternal risk factors responsible for anemia among preschool children. While, mother age, education and occupation has no role for occurrence of anemia among preschool children.
Adolescent↗
The quality of the caregiving environment and child developmental outcomes associated with maternal history of abortion using the NLSY data.
BACKGROUND: Studies suggest that experiencing a perinatal loss may leave women vulnerable to mental health problems and may compromise parenting. Unfortunately, compared to miscarriages and stillbirths, very little research has examined the potential for grief and feelings of loss associated with elective abortion. Therefore, the aim of this study was to compare the quality of the childcare environment and children's development among children of mothers with a history of abortion prior to childbirth (n = 672) and children of non post-abortive women (n= 4,172). METHOD: Data were derived from the National Longitudinal Survey of Youth (NLSY), with comparisons based on two assessments of the caregiving environment and scores on four child outcome variables. The sample was divided into three child age categories: 1-4 years (n = 1,502), 5-9 years (n = 2,121), and 10-13 years (n = 1,524). RESULTS: After controlling for numerous potentially confounding socio-demographic variables, lower scores were observed for the post-abortion group relative to the level of emotional support in the home among first-born children in the youngest age category. Further, among 5-9-year-olds, more behavior problems were revealed for the children of women with a history of abortion. Finally, no main effects were detected between the abortion history groups relative to the level of cognitive stimulation in the home. CONCLUSION: Although it is widely recognized that at least 10% of post-abortive women experience negative psychological consequences, the potential effects of negative subjective experiences on parenting need more systematic attention.
Abortion, Induced↗
Proportion of CD56+3+ T cells in decidual and peripheral lymphocytes of normal pregnancy and spontaneous abortion with and without history of recurrent abortion.
PROBLEM: The present study investigated the proportion of CD56+3+ T cells in maternal peripheral and decidual lymphocytes in normal pregnancy and spontaneous abortion with and without history of recurrent spontaneous abortion (RSA). METHOD OF STUDY: Maternal peripheral blood and decidua were taken from normal pregnancies and missed abortions with and without RSA. Decidual lymphocytes were prepared from decidual tissue and analyzed by flow cytometry. RESULTS: In normal pregnancy, the percentages of CD56+3+ T cells in decidual lymphocytes did not differ from those in the peripheral blood. However, the proportion of CD56+3+ T cells in decidual CD3+ T cells increased higher than that in the peripheral CD3+ T cells. The percentages of decidual CD56+3+ T cells in missed abortions with and without RSA were lower than those in normal pregnancies. CONCLUSION: CD56+3+ T cells may play a role in the maintenance of pregnancy. The phenomenon, where the proportion of CD56+3+ T cells in decidual lymphocytes decreases, may be due to an immunologic event leading to missed abortion.
Abortion, Habitual↗
Burden of abortion: induced and spontaneous.
BACKGROUND: Abortion is a public health concern because of its impact on maternal morbidity and mortality. Each year, about 79 million unintended pregnancies, excluding miscarriage, occur worldwide. More than half of these unintended pregnancies end in abortion. The purpose of this study was to determine the ever-event incidence of abortion (spontaneous and induced) and some related factors in a population-based sample of reproductive age women. METHODS: From July 2003 through January 2004, 2470 women were included in the study through multistage random sampling and were interviewed. Data were collected using a checklist with questions about demographics and specific items regarding abortion history. Information about age, literacy, gravidity, marriage age, abortion, type of abortion, family history of abortion, history of family marriage, smoking, drug use, alcohol use, coffee intake, and incidence of abortion during the previous year were recorded. Statistical analysis included Student's t-test, Chi-square, ANOVA, and logistic regression using SPSS software. RESULTS: Out of the 2,470 women in the study, 775 (45.7%), had at least one abortion in their lives. Of the women who had an abortion, 20.6% reported induced abortion and 74.2% reported spontaneous abortion. Forty-one point four percent of women aged 45 years and older had at least one abortion in their lifetime. Fifty-one (2.1%) women had a history of abortion during the previous year; the largest proportion was 5.4% for the age group 15 - 24 years. The most common method of induced abortion in the previous year was dilatation and curettage (42 to 67%). In multivariate analysis, household number, coffee consumption, gravidity, smoking, and history of abortion in the family were the most important factors related to abortion in the different age groups of women. CONCLUSION: This study shows that the occurrence of at least one abortion in the life of women in our setting is high and varies by age group. There is a need for expanded comprehensive sexual and reproductive health services, and more education and accessibility of contraception methods.
Abortion, Induced↗
Neural-tube defects: importance of a history of abortion in aetiology.
The overall incidence of anencephaly and spina bifida (ASB) in 69,056 pregnancies was 4.7/1000 births. ASB was more common (8.4/1000 births) among children of mothers who had had two or more abortions, but the increased risk was confined to spina bifida. A history of abortion was more common in older women and women of higher parity, but this was not matched by a similar increase in the incidence of ASB. The incidence of ASB was related to social class, but the prevalence of previous abortions was similar in all classes. The results suggest that expectant mothers with a history of two or more abortions have an increased risk of producing a child with spina bifida. The abortions are considered to be a manifestation of previous abnormal conceptions rather than the primary cause.
Abortion, Spontaneous↗
Early pregnancy predictors of preterm birth: the role of a prolonged menstruation-conception interval.
OBJECTIVE: To study early pregnancy characteristics as possible risk factors associated with preterm birth. DESIGN: Retrospective analysis of prospectively collected maternity data. POPULATION: 21,069 singleton deliveries with record of a specified last menstrual period and a midtrimester dating scan. SETTING: Catchment area of tertiary centre serving a general maternity population. METHODS: Univariate and multivariate analysis. Variables included: maternal age; height; weight at first visit; parity; ethnic group; cigarette smoking and alcohol consumption recorded in early pregnancy; history of abortion; history of preterm birth; and discrepancy between menstrual dates and ultrasound dates. MAIN OUTCOME MEASURES: Adjusted odds ratios for factors associated with preterm birth, stratified according to parity (nulliparae vs multiparae) and gestational age (early preterm, 24-33 weeks; late preterm, 34-36 weeks; all preterm, < 37 weeks). Population attributable risk (aetiologic fraction) of the significant variables for preterm birth. RESULTS: The overall preterm (< 37 weeks) delivery rate according to scan dates was 7 x 0%. Preterm birth was associated with young (< 20 years), short (< or = 155 cm) and underweight (< or = 52 kg) mothers, non-Europeans, cigarette smokers, previous abortion or previous preterm delivery, and a prolonged menstruation-conception interval. Preterm births which followed the spontaneous onset of labour (72%) had results which were similar to the overall group, while there were too few iatrogenic preterm deliveries for separate analysis. Logistic regression showed that associations varied in different parity and gestational age groups. For nulliparae, smoking was not associated with preterm birth, but it was strongly associated with multiparous women (adjusted OR 1 x 8, 95% CI 1 x 6-2 x 1). A past history of premature delivery had the highest risk for birth before 34 weeks in the index pregnancy (adjusted OR 5 x 1, 95% CI 3 x 4-7 x 6). A discrepancy between menstrual and scan dates of greater than +7 days, suggestive of a prolonged interval between last menstruation and conception, was present in 23 x 3% of all pregnancies, and was associated with an increased risk of preterm delivery in all gestational age categories for nulliparae (adjusted OR 1 x 5, 95% CI 1 x 3-1 x 8) and multiparae (adjusted OR 1 x 9, 95% CI 1 x 6-2 x 2). Because of its high prevalence, this variable constituted a relatively high population-attributable risk for premature birth for both nulliparae (10 x 7%) and multiparae (16 x 6%). CONCLUSIONS: A discrepancy of more than +7 days between menstrual and scan dates, indicating a prolonged interval between last menstruation and conception, is a significant predictor of preterm birth. This effect is independent of other factors such as maternal age, height, weight and smoking which are also associated with prematurity. In a maternity population with ultrasound scan dates and recorded last menstrual period, this variable can be easily calculated and used as a marker for increased surveillance.
Analysis of Variance↗
Seroprevalence of Neospora caninum infection following an abortion outbreak in a dairy cattle herd.
OBJECTIVE: To investigate the seroprevalence of Neospora caninum infection in a commercial dairy cattle herd, 15 months after detection of an abortion outbreak. PROCEDURE: Sera from the whole herd (n = 266) were examined for N caninum antibodies by indirect fluorescent antibody test (IFAT) and immunoblot analysis. Herd records were reviewed to collate serological results with abortion history, proximity to calving, and pedigree data. RESULTS: The seroprevalence of N caninum infection was 24% (63/266) for IFAT titre > or = 160, 29% (78/266) for immunoblot positive (+ve), and 31% (82/266) for IFAT > or = 160 and/or immunoblot +ve; 94% (59/63) of animals with IFAT > or = 160 were immunoblot +ve. The association between seropositivity (IFAT > or = 160 and/or immunoblot +ve) and history of abortion was highly significant (P < 0.001); the seroprevalence was 86% (18/21) in aborting cows, compared with 30% (50/164) in non-aborting animals. The abortion rate for seropositive cows was 26% (18/68) compared with 3% (3/117) for seronegative animals. IFAT titres of infected cows were higher within 2 months of calving than at other times (P < 0.001). The association between seropositivity in dams and daughters was highly significant (P = 0.009). CONCLUSIONS: The abortions were associated with N caninum infection and there was evidence of reactivation of latent infection close to calving and congenital transmission of infection. Immunodominant antigens identified by immunoblots may prove useful for improved diagnostic tests.
Abortion, Veterinary↗
History of abortion and subsequent risk of preeclampsia.
OBJECTIVE: To examine the effect of abortion type, number and timing on risk of preeclampsia in subsequent pregnancies. STUDY DESIGN: We conducted a hospital-based, case-control study in Seattle and Tacoma, Washington, between 1998 and 2001. Preeclampsia cases (n = 199) and controls (n = 383) provided detailed information regarding their pregnancy histories and other covariates, such as prepregnancy weight and adult height. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated by logistic regression. RESULTS: Multiparous women, both with a history of abortion and without, experienced decreases of 60% (adjusted OR = 0.40, 95% CI .23-.71) and 71% (adjusted OR = .29, 95% CI .16-.53), respectively, in risk of preeclampsia when compared to nulliparous women with no history of abortion. Type (spontaneous and/or induced), number and timing of prior abortion did not appear to influence the risk of preeclampsia among nulliparous women. CONCLUSION: These results confirm the work of others that multiparous women, both with and without a history of abortion, have a reduced risk of preeclampsia. However, much work remains with respect to exploring mechanistic hypotheses offering biologic explanations and examining possible confounding factors of this association, such as change in paternity and interpregnancy interval.
Abortion, Induced↗
Predictive factors in recurrent spontaneous aborters--a multicenter study.
PROBLEM: Compare data from several centers relating to success rates in recurrent spontaneous miscarriage and assess the significance of indicators of subsequent pregnancy loss. METHOD: Data from 777 couples with unexplained recurrent spontaneous abortion from independent studies at seven centers were analyzed using logistic regression analysis. The following covariates were considered: age of patient, number of previous spontaneous abortions, length of previous abortions history, sub-fertility index (defined as the product of the number of spontaneous abortions and the abortion history), whether a patient was a primary or secondary aborter, and whether a patient had received leukocyte immunotherapy. RESULTS: There was a highly significant difference between the seven centers in success rates in the subsequent pregnancy and a highly significant association between success rate and each of the following covariates: the number of previous abortions, the length of the previous abortion history and the sub-fertility index. In particular, for each increase of 10 units in the value of the sub-fertility index, up to a value of 30, the odds in favor of a successful pregnancy decreased by a factor of 0.6, i.e., 40%. There was, however, little evidence of an association between the success rate in the subsequent pregnancy and age, parity, or immunization with cells from the husband. CONCLUSIONS: The sub-fertility index may be a useful measure of likelihood of success in a subsequent pregnancy.
Abortion, Habitual↗
[Acquired hemophilia A after an early abortion].
HISTORY: A 30-year-old woman was referred to our clinic because she had developed recurrent spontaneous hematomas of both calves within the last 2 months. 6 months earlier the patient had developed an ovarian hyperstimulation syndrome after ovarian stimulation treatment and intrauterine insemination. Shortly afterwards a missed abortion (8 (th) week) had been diagnosed. A curettage was carried out. INVESTIGATIONS: Routine coagulation tests confirmed a prolongation of aPTT to 90 s and a lupus anticoagulant. A high-titre factor VIII inhibitor (56 Bethesda units) was identified. TREATMENT AND COURSE: Given these facts an acquired post-partum hemophilia was diagnosed. The patient was treated with prednisolone and immunoglobulins. The aPTT shortened to normal values. The factor VIII inhibitor and lupus anticoagulant disappeared. There were no further hematomas. CONCLUSIONS: The simultaneous occurrence of antibodies in an altered immune state such as pregnancy is well known. In our case, acquired factor VIII inhibitor was found after an early abortion. Treatment with steroids and immunoglobulines led to the disappearance of factor VIII inhibitor and lupus anticoagulant.
Abortion, Missed↗
Cytogenetic findings in fifty-five couples with recurrent fetal wastage.
Balanced chromosomal translocations in parents and Müllerian abnormalities constitute defined causes of reproductive wastage. Fifty-nine couples with histories of recurrent abortion with or without fetal malformations were evaluated with cytogenetic studies and gynecography. In 44 of the couples with pure abortion histories of two or more spontaneous abortions, three (6.8%) balanced carrier parents were identified. In 11 couples with a mixed history of abortion plus fetal malformation, 3 (27.3%) had balanced translocations in one of the parents. The over-all incidence of Müllerian abnormalities in the group of 59 patients was 11.9%.
Abortion, Habitual↗