Stephen J McCall1, Gillian Flett2, Emmanuel Okpo3, Sohinee Bhattacharya4. 1. Research Assistant, Epidemiology Group, Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, University of Aberdeen, Aberdeen, UK DPhil Student, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK. 2. Consultant in Sexual and Reproductive Health, Department of Sexual Health, NHS Grampian, Aberdeen, UK. 3. Consultant in Public Health Medicine, Department of Public Health, NHS Grampian, Aberdeen, UK. 4. Senior Lecturer, in Obstetric Epidemiology Epidemiology Group, Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, University of Aberdeen, Aberdeen, UK.
Abstract
BACKGROUND: Repeat termination of pregnancy highlights the issues of unplanned pregnancies and effective post-termination contraceptive practices. OBJECTIVE: To examine the risk factors at the time of a first termination that are associated with subsequent repeat termination. DESIGN: Registry-based study. SETTING: Grampian region of Scotland, UK. METHODS: A retrospective study using data from the Termination of Pregnancy Database, NHS Grampian for the period 1997-2013. Associations between repeat termination and women's sociodemographic characteristics and contraceptive use were assessed using multivariable logistic regression models. RESULTS: This study showed that 23.4% of women who had an initial termination (n=13 621) underwent a repeat termination. Women who had repeat terminations were more likely to be aged under 20 years at their initial termination with an adjusted odds ratio (AOR) of 5.59 [95% confidence interval (CI) 4.17-7.49], to belong to the most deprived social quintile [AOR 1.23 (95% CI 1.05-1.43)], and to be more likely to have had two or more previous livebirths [AOR 1.51 (95% CI 1.12-2.02)] or miscarriages [AOR 1.40 (95% CI 1.02-1.92)]. The likelihood of having a repeat termination was increased in women who had a contraceptive implant as post-termination contraception [AOR 1.78 (95% CI 1.50-2.11)] compared to women who left with none or unknown methods following the first termination. In those who had repeat terminations, women who had an implant or Depo-Provera(®) were at increased odds of repeat termination in the 2-5 years interval compared to the 0-2 years after their initial termination. CONCLUSIONS: Teenage pregnancy, social deprivation, two or more previous livebirths or miscarriages at the time of the initial termination were identified as risk factors for repeat terminations. Post-termination contraception with implants and Depo-Provera® were associated with repeat termination 2-5 years after the first termination. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: Repeat termination of pregnancy highlights the issues of unplanned pregnancies and effective post-termination contraceptive practices. OBJECTIVE: To examine the risk factors at the time of a first termination that are associated with subsequent repeat termination. DESIGN: Registry-based study. SETTING: Grampian region of Scotland, UK. METHODS: A retrospective study using data from the Termination of Pregnancy Database, NHS Grampian for the period 1997-2013. Associations between repeat termination and women's sociodemographic characteristics and contraceptive use were assessed using multivariable logistic regression models. RESULTS: This study showed that 23.4% of women who had an initial termination (n=13 621) underwent a repeat termination. Women who had repeat terminations were more likely to be aged under 20 years at their initial termination with an adjusted odds ratio (AOR) of 5.59 [95% confidence interval (CI) 4.17-7.49], to belong to the most deprived social quintile [AOR 1.23 (95% CI 1.05-1.43)], and to be more likely to have had two or more previous livebirths [AOR 1.51 (95% CI 1.12-2.02)] or miscarriages [AOR 1.40 (95% CI 1.02-1.92)]. The likelihood of having a repeat termination was increased in women who had a contraceptive implant as post-termination contraception [AOR 1.78 (95% CI 1.50-2.11)] compared to women who left with none or unknown methods following the first termination. In those who had repeat terminations, women who had an implant or Depo-Provera(®) were at increased odds of repeat termination in the 2-5 years interval compared to the 0-2 years after their initial termination. CONCLUSIONS: Teenage pregnancy, social deprivation, two or more previous livebirths or miscarriages at the time of the initial termination were identified as risk factors for repeat terminations. Post-termination contraception with implants and Depo-Provera® were associated with repeat termination 2-5 years after the first termination. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Jinlin Liu; Shangchun Wu; Jialin Xu; Marleen Temmerman; Wei-Hong Zhang Journal: Int J Environ Res Public Health Date: 2019-03-05 Impact factor: 3.390
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