Frank P I, McNamee R, Hannaford P C, Kay C R, Hirsch S
Royal College of General Practitioners, Manchester Research Unit.
Br J Obstet Gynaecol. 1991 Oct;98(10):1015-24. doi: 10.1111/j.1471-0528.1991.tb15340.x.
To investigate the effect of induced abortion on the outcome of the next pregnancy.
Long-term prospective controlled cohort study.
Joint Royal College of General Practitioners/Royal College of Obstetricians and Gynaecologists study based in general practice in England, Scotland and Wales.
1311 women whose recruitment pregnancy had ended in induced abortion (the abortion group) and 2131 women whose recruitment pregnancy had a natural conclusion (the non-abortion group).
Non-viable outcome (spontaneous or missed miscarriage, ectopic pregnancy or stillbirth), birthweight, length of gestation.
Induced abortion was not materially associated with any of the three measures of adverse outcome. Compared with the non-abortion group the relative risk of a non-viable outcome in the abortion group was 1.01 (95% CI 0.81 to 1.27). In the abortion group birthweight was an average 23 g lighter (95% CI -76 g to + 30 g) and length of gestation an average 0.9 days shorter (95% CI -2.2 days to + 0.4 days) than in the non-abortion group. Women who had their abortions in NHS premises had an increased risk of a non-viable outcome (RR 2.55, 95% CI 1.31 to 4.94) and had babies with significantly lower mean birthweight (-119 g, 95% CI -233 g to +5 g) compared with those who obtained their operations in the private sector. Women whose abortion had been carried out by a consultant had the lowest risk of non-viable outcome. Although these differences remained after adjustment for a number of important variables, it is possible that factors not measured in the present study, such as economic status and occupation, played a contributory role.
Overall, induced abortion was not associated with any important effect on the three measures of adverse outcome in the subsequent pregnancy.
探讨人工流产对下次妊娠结局的影响。
长期前瞻性对照队列研究。
基于英格兰、苏格兰和威尔士全科医疗的皇家全科医师学院/皇家妇产科学院联合研究。
1311名招募妊娠以人工流产告终的女性（流产组）和2131名招募妊娠自然结束的女性（非流产组）。
不良结局（自然流产或稽留流产、异位妊娠或死产）、出生体重、妊娠时长。
人工流产与三项不良结局指标均无实质性关联。与非流产组相比，流产组出现不良结局的相对风险为1.01（95%可信区间0.81至1.27）。流产组的出生体重平均轻23克（95%可信区间-76克至+30克），妊娠时长平均短0.9天（95%可信区间-2.2天至+0.4天）。在国民保健服务机构进行人工流产的女性出现不良结局的风险增加（相对风险2.55，95%可信区间1.31至4.94），与在私立机构进行手术的女性相比，其婴儿的平均出生体重显著更低（-119克，95%可信区间-233克至+5克）。由顾问实施人工流产的女性出现不良结局的风险最低。尽管在对一些重要变量进行调整后这些差异仍然存在，但本研究未测量的因素，如经济状况和职业，可能也起到了一定作用。
总体而言，人工流产与后续妊娠的三项不良结局指标均无重要关联。
