Zhou W, Olsen J, Nielsen G L, Sabroe S
The Danish Epidemiology Science Centre, Aarhus University, Denmark.
J Obstet Gynaecol. 2000 Jan;20(1):49-54. doi: 10.1080/01443610063462.
We set out to study the risk of spontaneous abortion following a first trimester induced abortion as a function of the interpregnancy interval between two pregnancies. The cohort study is based on the following databases: Danish national registries: the Medical Birth Registry (MBR), the Hospital Discharge Registry (HDR), and the induced Abortion Registry (IAR). All primigravid women in the time period from 1980 to 1982 were identified in the MBR, the HDR and the IAR. A total of 15 727 women who terminated the pregnancy with a first trimester induced abortion were selected as the induced abortion cohort, and 46 026 women who did not terminate the pregnancy with an induced abortion constituted the control cohort. By register linkage all subsequent pregnancies which were not terminated by induced abortion were identified from 1980 to 1994. Only women who had a non-terminated pregnancy following the index pregnancy were selected. Women whose first pregnancy was terminated following a first trimester induced abortion had a risk of spontaneous abortion of 11.0% vs. 9.4% in the control cohort. This relative difference of 1.17 was not statistically significant in logistic regression analyses. An increased risk was only found for women who had an interpregnancy interval of less than 3 months (OR=4.06, 95% C.I.=1.98-8.31). The abortion method, vacuum aspiration with dilatation or evacuation with dilatation did not modify this elevated risk. Overall the study did not show an increased risk of spontaneous abortion following one or more induced abortions, except for women with a short interpregnancy interval between an induced abortion and a subsequent pregnancy. We recommend women who have a first trimester induced abortion be advised to wait at least 3-6 months before trying to become pregnant again.
我们着手研究孕早期人工流产后自然流产的风险与两次妊娠之间的妊娠间隔的关系。该队列研究基于以下数据库：丹麦国家登记处：医学出生登记处（MBR）、医院出院登记处（HDR）和人工流产登记处（IAR）。在MBR、HDR和IAR中确定了1980年至1982年期间所有的初孕妇。共有15727名在孕早期进行人工流产终止妊娠的妇女被选为人工流产队列，46026名未进行人工流产终止妊娠的妇女构成对照队列。通过登记链接，确定了1980年至1994年期间所有未因人工流产而终止的后续妊娠。仅选择在索引妊娠后有未终止妊娠的妇女。首次妊娠在孕早期人工流产后终止的妇女自然流产风险为11.0%，而对照队列中的风险为9.4%。在逻辑回归分析中，这种1.17的相对差异无统计学意义。仅在妊娠间隔小于3个月的妇女中发现风险增加（OR = 4.06，95%可信区间 = 1.98 - 8.31）。人工流产方法，即扩张后真空吸引或扩张后刮宫，并未改变这种升高的风险。总体而言，该研究未显示一次或多次人工流产后自然流产风险增加，除了人工流产与随后妊娠之间妊娠间隔短的妇女。我们建议，对在孕早期进行人工流产的妇女，建议她们在尝试再次怀孕前至少等待3至6个月。
