Oskari Heikinheimo1, Mika Gissler, Satu Suhonen. 1. Department of Obstetrics and Gynaecology, University of Helsinki, PO Box 140, SF-00029, HUS, Finland. oskari.heikinheimo@helsinki.fi
Abstract
BACKGROUND: Factors predicting the outcome of the next pregnancy following termination of pregnancy (TOP) are poorly known. METHODS: A cohort of 1269 women undergoing medical TOP between 2000 and 2002 were followed up until the next pregnancy or until the end of 2006, using registers of induced abortion, births and hospital discharges. Factors associated with repeat TOP, delivery and failed pregnancy were analysed. RESULTS: During the mean (+/-SD) follow-up period of 4.2 +/- 1.5 years, 446 (35%) women had at least one subsequent pregnancy. Of these, 207 (46%) resulted in delivery, 169 (38%) in repeat TOP and 16% in failed pregnancy. In multivariate analysis, parity [hazard ratio (HR) 3.42, 95% confidence interval (CI) 1.70-6.91] and history of TOP (HR 1.60, 95% CI 1.10-2.33) were risk factors of repeat TOP. Age above 25 years (HR < or = 0.46) and the use of intrauterine contraception (HR < or = 0.45) were associated with reduced risks of repeat TOP. However, only age between 25 and 29 years was associated with an increased probability of delivery (HR 2.44, 95% CI 1.45-4.11). CONCLUSIONS: Risk factors of repeat TOP are more clearly defined than factors associated with delivery. An increased focus on young women, those with a history of TOP and parous women, might be effective in reducing repeat TOP.
BACKGROUND: Factors predicting the outcome of the next pregnancy following termination of pregnancy (TOP) are poorly known. METHODS: A cohort of 1269 women undergoing medical TOP between 2000 and 2002 were followed up until the next pregnancy or until the end of 2006, using registers of induced abortion, births and hospital discharges. Factors associated with repeat TOP, delivery and failed pregnancy were analysed. RESULTS: During the mean (+/-SD) follow-up period of 4.2 +/- 1.5 years, 446 (35%) women had at least one subsequent pregnancy. Of these, 207 (46%) resulted in delivery, 169 (38%) in repeat TOP and 16% in failed pregnancy. In multivariate analysis, parity [hazard ratio (HR) 3.42, 95% confidence interval (CI) 1.70-6.91] and history of TOP (HR 1.60, 95% CI 1.10-2.33) were risk factors of repeat TOP. Age above 25 years (HR < or = 0.46) and the use of intrauterine contraception (HR < or = 0.45) were associated with reduced risks of repeat TOP. However, only age between 25 and 29 years was associated with an increased probability of delivery (HR 2.44, 95% CI 1.45-4.11). CONCLUSIONS: Risk factors of repeat TOP are more clearly defined than factors associated with delivery. An increased focus on young women, those with a history of TOP and parous women, might be effective in reducing repeat TOP.
Authors: James Studnicki; Tessa Longbons; David C Reardon; John W Fisher; Donna J Harrison; Ingrid Skop; Christina A Cirucci; Christopher Craver; Maka Tsulukidze; Zbigniew Ras Journal: Health Serv Res Manag Epidemiol Date: 2022-10-11