Repeat abortions have repercussions for later pregnancy

Women who have had three or more previous abortions have a significantly increased risk for having a first baby who is premature or of low birthweight.

The study of 300,858 Finnish mothers showed that women who had three or more induced abortions before a first singleton birth had a 35% increased risk for giving birth to a premature baby (<37 weeks' gestation). They also had a significant 43% increased risk for giving birth to a baby weighing less than 2500 g and a 2.25-fold increased risk for giving birth to a baby weighing less than 1500 g.

"We suggest that the potential for increased risks for subsequent births should be included in sex education, especially as there are other, good reasons to avoid induced abortions," remarked lead author Reija Klemetti (National Institute for Health and Welfare, Helsinki, Finland) in a press statement.

"Health professionals should also be informed about the potential risks of repeat abortions."

Overall, 31,083 (10.3%) of mothers with a first singleton birth between 1996 and 2008 had previously undergone one induced abortion, 4417 (1.5%) two abortions, and 942 (0.3%) three or more abortions. Ninety-seven percent of the abortions were performed for nonmedical reasons.

The risk for having a premature baby increased slightly with each induced abortion, but this increase was statistically significant only after three abortions or more.

"To put these risks into perspective, for every 1000 women, three who have had no abortions will have a baby born under 28 weeks," explained Klemetti. "This rises to four women among those who have had one abortion, six women who have had two abortions, and 11 women who have had three or more."

The study also showed a small increased risk for infant mortality around the time of birth, at 1498 births or five per 1000 babies. However, this result "should be treated with caution," said Klemetti, as it was not fully adjusted for all potential confounders including social factors such as poverty.

"Finland has one of the lowest rates of induced abortion in Europe, but even so, a large number are carried out every year. In addition, Finland has good quality abortion and maternity care, and in other contexts, particularly in poorer countries, the situation may be different," Klemetti said.

The findings were published in Human Production.

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