Outcomes of 19 pregnant women with brucellosis in Babol, northern Iran

From April 2000 to March 2010, 19 pregnant women with brucellosis were evaluated, treated and followed up. Ten (53%) pregnant women had spontaneous abortions. Six of eleven (55%) women infected in the first trimester had a spontaneous abortion. After treatment, all subsequently became pregnant and gave birth to normal babies. Among 13 patients who received cotrimoxazole plus rifampin, only four (31%) aborted and nine mothers had normal term deliveries. Two patients with recurrent abortions had brucellosis and became pregnant and gave birth after treatment. The brucellosis screening program for pregnant women and those with spontaneous abortion is necessary in brucellosis endemic regions.     

A portrait of American women who obtain abortions

In 1981, as in 1980, most abortions in the United States were obtained by young women, unmarried women and white women, and were performed in the first eight weeks following the last menstrual period (approximately six weeks after conception). The proportion of abortions obtained by unmarried women has increased slightly, and the fraction obtained by teenagers has decreased, mainly because of shifts in the distribution of these groups in the population. The percentage of abortions that are repeat procedures has increased, representing more than one-third of all abortions. The increase is due largely to the rise in the number of women who have had a first abortion, and who are, therefore, exposed to the risk of having a second procedure. Eighty-five percent of all abortions are performed by vacuum aspiration. Dilatation and evacuation is the method used in two-thirds of abortions performed more than 12 weeks past the last menstrual period, and in nine out of 10 abortions that are performed between the 13th and the 15th week. About three percent of women aged 15-44 obtained abortions in 1981, and 26 percent of pregnancies were terminated by abortion--the same fractions as in 1980. About six percent of 18-19-year-olds had abortions--the highest rate of any age-group. The abortion rate (the number of abortions per 1,000 women aged 15-44) and ratio (the number of abortions per 100 live births and abortions) are much higher for unmarried than for married women.(ABSTRACT TRUNCATED AT 250 WORDS)     

Unintended pregnancy among American women

This research note presents new estimates of the proportion of American women of reproductive age who experience unintended pregnancies, unintended births and abortions. The data are based on tabulations from the 1982 National Survey of Family Growth (NSFG) and the Alan Guttmacher Institute's 1981-1982 national survey of abortion providers. Of 6.1 million women who became pregnant in 1982, 3.7 million gave birth, 1.6 million had abortions and 0.9 million experienced miscarriages. An estimated 37% of all births in the 5 years preceding the 1982 NSFG were unintended. Applying that proportion to 1982 births results in an estimate of 1.3 million unintended births. It can be assumed that all 1.6 million abortions were terminations of unintended pregnancies. Respondents in the 1982 NSFG reported that 40% of the births they had ever had were unintended. 33% of NSFG respondents said that they had had at least 1 unintended birth during their life. Abortions were seriously underreported in the NSFG, as they have been in most other surveys. Only 47% of the abortions that occurred during the period 1977-1981 were reported. The real proportion of women of reproductive age who have ever had an abortion appears to be 21%. 65% of all women aged 40-44 in 1982 had had at least 1 unintended pregnancy, and more than 1/3 of them had had at least 1 abortion. It is probably inappropriate to view these levels as representative of the proportions of today's young women who will ever experience an unintended pregnancy or abortion. Estimates of the proportion of women who will have had abortions by age 45 indicate that 18% of women will have had a 1st abortion by age 20; 41% will have had one by age 30; and 46%, by age 45.     

Induced abortion and low birthweight in the following pregnancy

BACKGROUND: To examine whether induced abortion increases the risk of low birthweight in subsequent singleton live births. METHODS: Cohort study using the Danish Medical Birth Registry (MBR), the Hospital Discharge Registry (HDR), and the Induced Abortion Registry (IAR). All women who had their first pregnancy during 1980-1982 were identified in the MBR, the HDR, and the IAR. We included all 15,727 women whose pregnancy was terminated by a first trimester induced abortion in the induced abortion cohort and 46,026 women whose pregnancy was not terminated by an induced abortion were selected for the control cohort. All subsequent pregnancies until 1994 were identified by register record linkage. RESULTS: Low birthweight (<2500 g) in singleton term live births occurred more frequently in women with one, two, three or more previous induced abortions, compared with women without any previous induced abortion of similar gravidity, 2.2% versus 1.5%, 2.4% versus 1.7%, and 1.8% versus 1.6%, respectively. Adjusting for maternal age and residence at time of pregnancy, interpregnancy interval, gender of newborn, number of previous spontaneous abortions and number of previous low birthweight infants (control cohort only), the odds ratios (OR) of low birthweight in singleton term live births in women with one, two or more previous first trimester induced abortions were 1.9 (95% CI: 1.6, 2.3), and 1.9 (95% CI: 1.3, 2.7), respectively, compared with the control cohort of similar gravidity. High risks were mainly seen in women with an interpregnancy interval of more than 6 months. CONCLUSIONS: The findings suggest a positive association between one or more first trimester induced abortions and the risk of low birthweight in subsequent singleton term live births when the interpregnancy interval is longer than 6 months. This result was unexpected and confounding cannot be ruled out.     

Estimating the probability of spontaneous abortion in the presence of induced abortion and vice versa.

An integrated approach to estimate the total number of pregnancies that begin in a population during one calendar year and the probability of spontaneous abortion is described. This includes an indirect estimate of the number of pregnancies that result in spontaneous abortions. The method simultaneously takes into account the proportion of induced abortions that are censored by spontaneous abortions and vice versa in order to estimate the true annual number of spontaneous and induced abortions for a population. It also estimates the proportion of pregnancies that women intended to allow to continue to a live birth. The proposed indirect approach derives adjustment factors to make indirect estimates by combining vital statistics information on gestational age at induced abortion (from the 12 States that report to the National Center for Health Statistics) with a life table of spontaneous abortion probabilities. The adjustment factors are applied to data on induced abortions from the Alan Guttmacher Institute Abortion Provider Survey and data on births from U.S. vital statistics. For the United States in 1980 the probability of a spontaneous abortion is 19 percent, given the presence of induced abortion. Once the effects of spontaneous abortion are discounted, women in 1980 intended to allow 73 percent of their pregnancies to proceed to a live birth. One medical benefit to a population practicing induced abortion is that induced abortions avert some spontaneous abortions, leading to a lower mean gestational duration at the time of spontaneous abortion.     

Previous abortion and the risk of low birth weight and preterm births

OBJECTIVE: To investigate the association between previous abortion and low birth weight (LBW) and preterm birth (PB). METHOD: The study examined live, singleton births using data from the United States Collaborative Perinatal Project. Logistic regression was used to control for obstetric and medical history, and lifestyle and demographic factors. RESULT: Compared with women with no history of abortion, women who had one, two and three or more previous abortions were 2.8 (95% CI 2.48 to 3.07), 4.6 (95% CI 3.94 to 5.46) and 9.5 (95% CI 7.72 to 11.67) times more likely to have LBW, respectively. The risk for PB was also 1.7 (95% CI 1.52 to 1.83), 2.0 (95% CI 1.73 to 2.37) and 3.0 (95% CI 2.47 to 3.70) times higher for women with a history of one, two and three or more previous abortions, respectively. CONCLUSION: Previous abortion is a significant risk factor for LBW and PB, and the risk increases with the increasing number of previous abortions. Practitioners should consider previous abortion as a risk factor for LBW and PB.     

Spontaneous abortions among women working in the pharmaceutical industry

A register based study was conducted on the pregnancy outcome of female workers in eight Finnish pharmaceutical factories to determine whether they had a higher risk of spontaneous abortion than the general population or matched controls. Information about all female workers who had been employed in the factories during the years 1973 or 1975 (four factories) to 1980 was obtained from the employers. The workers' pregnancy data were collected from the nation wide hospital discharge register and polyclinic data of hospitals from 1973 to 1981. The total number of 1795 pregnancies included 1179 deliveries, 142 spontaneous abortions, and 474 induced abortions. The spontaneous abortion rate (the number of spontaneous abortions X 100, divided by the number of spontaneous abortions plus the number of births) during employment was 10.9% and before/after employment 10.6%. The rate for all the women in the corresponding central hospital districts was 11.3% [corrected] during the study period. A case-control study was also carried out in which the cases were 44 women who had a spontaneous abortion during employment in the pharmaceutical factory. Three age matched female pharmaceutical factory workers who had given birth to a child were chosen as controls for every case. The information about occupational exposures was collected from questionnaires completed by the occupational physician or nurse at the factory. The response rate was 93%. Exposure to chemicals was more common among the cases than among the controls. For methylene chloride, a solvent commonly used in the pharmaceutical industry, the increase in odds ratio of borderline significance (odds ratio 2.3, p = 0.06). In a logistic regression model (which included oestrogen exposure, solvent exposure frequency of the usage, and heavy lifting) the odds ratio was increased for oestrogens (odds ratio 4.2, p = 0.05) and for continuous heavy lifting (odds ratio 5.7, p = 0.02). The odds ratio for spontaneous abortions was greater among those exposed to four or more solvents (odds ratio 3.5, p=0.05) than among those exposed to one to three solvents (odds ration 0.8, p=0.74).     

Reproductive health of immigrant women in the Lazio region of Italy

The number of legal immigrant women living in the Lazio region of Italy has increased in recent years; there were 69,320 "permessi di soggiorno" (temporary residence permits) issued in 1992 but 119,778 issued in 2000. This analysis concerns women who left hospital after having a live birth, an induced abortion or a spontaneous abortion. The foreign women were compared with all (Italian and foreign) women living in Lazio. The general fertility rate is slightly higher among all women resident in Lazio than among the foreign women, but the latter have a higher rate at ages 18-24 years. The risk of induced abortion is higher (34.8/1000 women) among the foreigners than among all residents (10.5/1000 women). The spontaneous abortion ratio was also higher among the foreigners (213.8/1000 live births) than the residents (154.6/1000 live births). There is clear evidence of an increase in the demand from foreign women for medical services for reasons associated with reproduction. The provision of these services needs to be modified to take account of their particular needs.     

Spontaneous abortions among women working in the pharmaceutical industry.

A register based study was conducted on the pregnancy outcome of female workers in eight Finnish pharmaceutical factories to determine whether they had a higher risk of spontaneous abortion than the general population or matched controls. Information about all female workers who had been employed in the factories during the years 1973 or 1975 (four factories) to 1980 was obtained from the employers. The workers' pregnancy data were collected from the nation wide hospital discharge register and polyclinic data of hospitals from 1973 to 1981. The total number of 1795 pregnancies included 1179 deliveries, 142 spontaneous abortions, and 474 induced abortions. The spontaneous abortion rate (the number of spontaneous abortions X 100, divided by the number of spontaneous abortions plus the number of births) during employment was 10.9% and before/after employment 10.6%. The rate for all the women in the corresponding central hospital districts was 11.3% [corrected] during the study period. A case-control study was also carried out in which the cases were 44 women who had a spontaneous abortion during employment in the pharmaceutical factory. Three age matched female pharmaceutical factory workers who had given birth to a child were chosen as controls for every case. The information about occupational exposures was collected from questionnaires completed by the occupational physician or nurse at the factory. The response rate was 93%. Exposure to chemicals was more common among the cases than among the controls. For methylene chloride, a solvent commonly used in the pharmaceutical industry, the increase in odds ratio of borderline significance (odds ratio 2.3, p = 0.06). In a logistic regression model (which included oestrogen exposure, solvent exposure frequency of the usage, and heavy lifting) the odds ratio was increased for oestrogens (odds ratio 4.2, p = 0.05) and for continuous heavy lifting (odds ratio 5.7, p = 0.02). The odds ratio for spontaneous abortions was greater among those exposed to four or more solvents (odds ratio 3.5, p=0.05) than among those exposed to one to three solvents (odds ration 0.8, p=0.74).     

Spontaneous abortions and birth defects related to tap and bottled water use, San Jose, California, 1980-1985.

We recently studied pregnancies occurring during 1980-1985 in four study areas in Santa Clara County, California. Two of the areas were exposed to solvent-contaminated drinking water during 1980 and 1981, and two were unexposed. There was an overall excess of spontaneous abortions among women who reported any tapwater consumption during the first trimester of pregnancy compared with those who reported no tapwater consumption [odds ratio (OR) = 4.0; 95% confidence interval (CI) = 1.8-9.1)], regardless of exposure to the contaminated water. The odds ratio for spontaneous abortion for women reporting any vs no tapwater was 6.9 (95% CI = 2.7-17.7) after adjustment for numerous potential confounders using multiple logistic regression analyses. The elevated odds ratio of spontaneous abortion was seen among tapwater drinkers who used no filters or softener-type filters but not among women who reported use of active filters. Spontaneous abortion rates were reduced in women who reported any vs no bottled water consumption (OR = 0.26; 95% CI = 0.16-0.43). Among women who reported no tapwater consumption, no birth defects occurred among 263 live births; in comparison, among women who reported tapwater consumption, 4% of 908 live births had defects (P = 0.0001). We observed no relation between birth defects and bottled water use.     

Modelling prior reproductive history to improve prediction of risk for very preterm birth

Watson LF, Rayner J‐A, King J, Jolley D, Forster D, Lumley J. Modelling prior reproductive history to improve prediction of risk for very preterm birth. Paediatric and Perinatal Epidemiology 2010. In published studies of preterm birth, analyses have usually been centred on individual reproductive events and do not account for the joint distributions of these events. In particular, spontaneous and induced abortions have often been studied separately and have been variously reported as having no increased risk, increased risk or different risks for subsequent preterm birth. In order to address this inconsistency, we categorised women into mutually exclusive groups according to their reproductive history, and explored the range of risks associated with different reproductive histories and assessed similarities of risks between different pregnancy histories. The data were from a population‐based case–control study, conducted in Victoria, Australia. The study recruited women giving birth between April 2002 and April 2004 from 73 maternity hospitals. Detailed reproductive histories were collected by interview a few weeks after the birth. The cases were 603 women who had had a singleton birth between 20 and less than 32 weeks gestation (very preterm births including terminations of pregnancy) and the controls were 796 randomly selected women from the population who had had a singleton birth of at least 37 completed weeks gestation. All birth outcomes were included. Unconditional logistic regression was used to assess the association of very preterm birth with type and number of prior abortions, prior preterm births and sociodemographic factors. Using the complex combinations of prior pregnancy experiences of women (including nulligravidity), we showed that a history of prior childbirth (at term) with no preterm births gave the lowest risk of very preterm birth. With this group as the reference category, odds ratios of more than two were associated with all other prior reproductive histories. There was no evidence of difference in risk between types of abortion (i.e. spontaneous or induced) although the risk increased if a prior preterm birth had also occurred. There was an increasing risk of very preterm birth associated with increasing numbers of abortions. This method of data analysis reveals consistent and similar risks for very preterm birth following spontaneous or induced abortions. The findings point to the need to explore commonalities rather than differences in regard to the impact of abortion on subsequent births.     

The analysis of trends in induced abortion in Japan—An increasing consequence among adolescents

Objectives  The purpose of this study was to examine trends in induced abortions in Japan. Methods  The Ministry of Health, Labour, and Welfare compiled data on induced abortions, live births, and the population of women aged 15–49 years. These data were provided by 47 prefectures in Japan and were used to examine the number of induced abortions and various characteristics of women who received abortions from 1955 through 2001. We examined abortion numbers, abortion ratios (number of legal abortions per 1,000 live births), and abortion rates (number of legal abortions per 1,000 women aged 15–49). We were particularly interested in examining abortion trends among adolescents. These trends were also compared to those in the United States. Results  A total of 341,588 legal induced abortions were reported in Japan in 2001, representing a 2.5% increase from 1998 to 2001. From 1998 to 2001, the abortion ratio (292) increased by 5.4%; from 1996 through 2001, the abortion rate (11.8) increased by 8.3%. Women less than 20 years old contributed most to these increases. In 1999, the abortion ratio among Japanese adolescents was 5.7 times as high as the ratio among U.S. adolescents, while the abortion rate among U.S. adolescents was 1.8 times as high as the rate among Japanese adolescents. Conclusions  Recent increases in induced abortion among Japanese women may be related to several factors, including changes in sexual behavior among adolescents and a decline in their use of contraceptives. More appropriate educational efforts and interventions are needed to prevent unintended pregnancies.     

高海拔地区藏族育龄妇女自然流产的流行病学特点

目的 了解中国高海拔地区15～49岁藏族育龄妇女自然流产状况。方法 采用横断面调查设计和分层多阶段抽样法获得样本，采用问卷调查西藏地区15～49岁藏族育龄妇女的生育史。结果 共调查3741名15～49岁的藏族育龄妇女，共计10245次妊娠，报告的自然流产386次，自然流产发生率为3墙％，城市妇女显著高于农村妇女，农牧区之间差异无统计学意义，育龄妇女发生自然流产的风险在控制了可能的影响因素后随着海拔高度的增加而增高。居住在海拔4500m以上的育龄妇女发生自然流产的风险是居住在海拔3500m以下妇女的近2倍多。年龄和妊娠的次数显著与自然流产的发生有正相关关系，35岁以上的育龄妇女和多次妊娠的妇女发生自然流产的风险增大。结论 高海拔可能独立的影响藏族妇女自然流产的发生，在高海拔地区更应加强健康教育和育龄妇女孕产期保健与营养，减少妊娠次数，延长生育间隔，以减少自然流产的发生。此外，回顾性的生育史调查可能会因回忆偏性等因素而低估了自然流产的发生，但西藏地区育龄妇女的自然流产水平不一定比平原地区高很多。     

Pregnancies,Abortions, and Births among Women with and without Borderline Personality Disorder

BackgroundThe purpose of this study was to examine history of pregnancies among women with and without borderline personality disorder (BPD), to determine whether BPD symptoms are associated with teenage pregnancies, unplanned pregnancies, elective and spontaneous abortions, and live births.MethodsThree hundred seventy-nine women completed the Structured Clinical Interview for DSM-IV Axis I diagnoses, Structured Interview for DSM-IV Personality for Axis II diagnoses, and a reproductive health interview. African-American (AA) women were oversampled, because little is known about BPD in AA women and they are at greater risk of teenage pregnancy, unplanned pregnancies, and spontaneous abortions.ResultsBPD symptom severity was associated with a teenage pregnancy, even after controlling for race and socioeconomic status. Symptom severity was also associated with unplanned pregnancies and live births, but only for women without a history of a substance use disorder. BPD symptom severity was not associated with abortion.ConclusionWomen with BPD become pregnant and have children, often during the period when BPD symptoms emerge and intensify. They are at increased risk of teenage pregnancies and unintended pregnancies compared with women with Axis I disorders. Treatment planning for this population should include attention to their reproductive health and better integration of physical and mental health services.     

Abortion surveillance, United States, 1984-1985

Since 1983, the number of legal abortions reported to CDC increased by 5% to 1,333,521 in 1984; in 1985, that number decreased by less than 1% to 1,328,570. The national abortion rate was the same for both years-24 per 1,000 females ages 15-44 years. The abortion ratio for 1984 was 364 legally induced abortions per 1,000 live births; the ratio for 1985 was 354 per 1,000. Abortion ratios were higher among women of black and other minority races and among women younger than 15 years of age. Women undergoing legally induced abortions tended 1) to be young, white, and unmarried, 2) to have had no previous live births, and 3) to be having the procedure for the first time. Curettage was the procedure used in 96% of the reported cases. Eleven deaths were associated with legally induced abortions in 1984, and six in 1985. The case-fatality rate in 1985 was 0.5 deaths per 100,000 legally induced abortions, down from the 0.8 per 100,000 reported in 1983 and 1984. Overall, since 1980, the numbers and rates of abortion have had only slight year-to-year fluctuations. The steady increase in the percentage of repeat abortions since 1972 reflects the ongoing availability of legal abortions. Since the beginning of CDC's abortion mortality surveillance, the number of deaths related to legal abortions has decreased 75%, from 24 deaths in 1972 to six deaths in 1985.     

Abortion surveillance--United States, 1989.

Since 1980, the number of legal induced abortions reported to CDC has remained stable, varying each year by < 5%. In 1989, 1,396,658 abortions were reported--a 1.9% increase from 1988. The abortion ratio for 1989 was 346 legal induced abortions/1,000 live births, and the abortion rate was 24/1,000 women ages 15-44 years. The abortion ratio was highest for black women and women of other minority racial groups and for women < 15 years of age. Overall, women undergoing abortions tended to be young, white, and unmarried; to have had no previous live births; and to be having the procedure for the first time. Approximately half of all abortions were performed before the eighth week of gestation, and 87% were before the thirteenth week of gestation. Younger women tended to obtain abortions later in pregnancy than older women. This report also includes newly reported abortion-related deaths for 1986 and 1987, as well as an update on abortion-related deaths for the period 1978-1985. Ten deaths in 1986 and six deaths in 1987 were associated with legal induced abortion. The case-fatality rate in 1986 was 0.8 abortion-related deaths/100,000 legal induced abortions and 0.4/100,000 in 1987.     

Abortion surveillance, 1986-1987

Since 1980, the number of legal abortions reported to CDC has remained fairly stable, varying each year by less than 3%. In 1986, 1,328,112 abortions were reported; in 1987, that number increased by approximately 2% to 1,353,671. The abortion ratio for 1986 was 354 legally induced abortions per 1,000 live births; the ratio for 1987 was 356 per 1,000. The national abortion rate was 23/1,000 females ages 15-44 years for 1986 and 24/1,000 females ages 15-44 years in 1987. Abortion ratios were higher among women of black and other minority races and among women less than 15 years of age. Women undergoing legally induced abortions tended 1) to be young, white, and unmarried, 2) to have had no previous live births, and 3) to be having the procedure for the first time. In 1987, approximately half of all abortions were performed before the eighth week of gestation, and greater than 85% were performed during the first trimester of pregnancy (less than 13 weeks of gestation).     

Abortion surveillance--United States, 1997.

PROBLEM/CONDITION: In 1969, CDC began abortion surveillance to document the number and characteristics of women obtaining legal induced abortions, to monitor unintended pregnancy, and to assist efforts to identify and reduce preventable causes of morbidity and mortality associated with abortions. REPORTING PERIOD COVERED: This report summarizes and reviews information reported to CDC regarding legal induced abortions obtained in the United States in 1997. DESCRIPTION OF SYSTEM: For each year since 1969, CDC has compiled abortion data by state where the abortion occurred. The data are received from 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. RESULTS: In 1997, a total of 1,186,039 legal abortions were reported to CDC, representing a 3% decrease from the number reported for 1996. The abortion ratio was 306 legal induced abortions per 1,000 live births, and since 1995, the abortion rate has remained at 20 per 1,000 women aged 15-44 years. The availability of information about characteristics of women who obtained an abortion in 1997 varied by state and by the number of states reporting each characteristic. The total number of legal induced abortions by state is reported by state of residence and state of occurrence; characteristics of women obtaining abortions in 1997 are reported by state of occurrence. Women who were undergoing an abortion were more likely to be young (i.e., aged < 25 years), white, and unmarried; approximately one half were obtaining an abortion for the first time. More than one half of all abortions for which gestational age was reported (55%) were performed at < or = 8 weeks of gestation, and 88% were performed before 13 weeks. Overall, 18% of abortions were performed at the earliest weeks of gestation (< or = 6 weeks), 18% at 7 weeks of gestation, and 20% at 8 weeks of gestation. From 1992 through 1997, increases have occurred in the percentage of abortions performed at the very early weeks of gestation. Few abortions were provided after 15 weeks of gestation--4% of abortions were obtained at 16-20 weeks, and 1.4% were obtained at > or = 21 weeks. A total of 19 reporting areas submitted information regarding abortions performed by medical (nonsurgical) procedures, comprising < 1% of procedures reported by all states. Younger women (i.e., aged < or = 24 years) were more likely to obtain abortions later in pregnancy than were older women. INTERPRETATION: From 1990 through 1995, the number of abortions declined each year; in 1996, the number increased slightly, and in 1997, the number of abortions in the United States declined to it lowest level since 1978. PUBLIC HEALTH ACTIONS: The number and characteristics of women who obtain abortions in the United States should continue to be monitored so that trends in induced abortion can be assessed and efforts to prevent unintended pregnancy can be evaluated.     

Risk of spontaneous abortion in Italy, 1978-1995, and the effect of maternal age, gravidity, marital status, and education

This paper describes the trend in the risk of spontaneous abortion in Italy from 1974 to 1995. There was a dramatic decline in the risk after the law that legalized induced abortion was passed in 1978, which implies that probably many induced abortions performed before 1978 were registered as spontaneous abortions. Data for 1991 have been extracted from the Italian national registers of births and abortions and analyzed to investigate the effects of maternal age, gravidity, marital status, and education on the risk of spontaneous abortion. In comparison with women under age 20 years, the risk is found to be increased for women aged 35-39 (odds ratio = 1.45) and women over age 40 (odds ratio = 3.10). The odds ratio is almost 2 for women who have been pregnant two or more times previously. Unmarried women have an increased risk (odds ratio = 1.33), but no important effect of education was observed. There is an important interaction between maternal age and gravidity. The risk of spontaneous abortion is excessively high for young women with high gravidity. It is hypothesized that this could be due to the effect of short intervals between pregnancies.     

育龄女性人工流产史与妊娠等待时间的相关性研究

目的:探讨育龄女性人工流产史与妊娠等待时间(TTP)关系。方法:采用回顾性队列研究方法,将2013年1月-2017年12月参加深圳市孕前优生健康检查且符合条件的44672例育龄女性作为研究对象,以20608例既往有人工流产史者为暴露组(其中14762例有1次人工流产史,5846例有≥2次人工流产史),以24064例无人工流产史者为非暴露组。采用Kruskal-walls检验和χ2检验比较不同组间的基线特征,Kaplan-Meier法计算每个月经周期的累计妊娠率,使用Cox模型估计育龄女性人工流产史对TTP的影响。结果:既往无人工流产史的育龄女性12个月经周期的累计妊娠率为(32.6%),低于既往有1次(38.9%)和≥2次人工流产史(34.0%)者。对影响因素进行调整后,与无人工流产史的育龄女性相比,有1次和≥2次人工流产史的女性生育力分别升高19.0%(FOR=1.190,95%CI 1.147~1.234)和21.5%(FOR=1.215,95%CI 1.153~1.280)。结论:有人工流产史的育龄女性生育力较高,TTP未见延长。针对这一生育力较高的特定人群,应做好科学避孕指导工作,避免多次意外妊娠后反复实施人工流产术对其生殖健康产生不良影响。