van Veen Teelkien R, Haeri Sina, Baker Arthur M
Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
St. David's Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas.
J Pediatr Adolesc Gynecol. 2015 Dec;28(6):530-2. doi: 10.1016/j.jpag.2015.03.012. Epub 2015 Apr 2.
The authors sought to determine whether pregnancies in adolescents following an abortion of pregnancy is associated with an elevated risk for adverse perinatal outcomes.
In a cohort study of all adolescent (younger than 18 years) deliveries over a 4-year period at 1 institution, we compared nulliparous women with a history of a prior abortion (cases) to those without a spontaneous loss or abortion of pregnancy (referent) for adverse perinatal outcomes, including preterm birth and fetal growth restriction.
Of the 654 included nulliparous adolescent deliveries, 102 (16%) had an abortion before the index pregnancy. Compared with the referent group, adolescents with a history of a abortion were older (17.8 ± 0.8 vs 16.7 ± 1.2 years, P = .0001), enrolled earlier for prenatal care (14.4 ± 5.6 vs 17.2 ± 7.6 weeks, P = .0004), along with a higher incidence of African American race (95% vs 88%, P = .05). The groups did not differ with respect to other maternal demographics. Perinatal outcomes, including spontaneous preterm birth, abnormal placentation, birth weight, and gestational age at delivery, did not differ between the 2 groups.
Compared with adolescent women who had just delivered and did not have a prior abortion, women who had just delivered and had a previous abortion were more likely to be older at the age of their first pregnancy and more likely to initiate early prenatal care. Thus, having a prior abortion may improve the health of a pregnancy though adverse outcomes do not differ between the 2 groups.
作者试图确定青少年在堕胎后怀孕是否与不良围产期结局风险升高有关。
在一项对某机构4年期间所有青少年（年龄小于18岁）分娩情况的队列研究中，我们将有过堕胎史的未生育女性（病例组）与无自然流产或堕胎史的女性（对照组）进行比较，以观察不良围产期结局，包括早产和胎儿生长受限。
在纳入研究的654例未生育青少年分娩中，102例（16%）在本次妊娠前有过堕胎史。与对照组相比，有堕胎史的青少年年龄更大（17.8±0.8岁对16.7±1.2岁，P = 0.0001），更早开始产前检查（14.4±5.6周对17.2±7.6周，P = 0.0004），非裔美国人种族的发生率也更高（95%对88%，P = 0.05）。两组在其他产妇人口统计学特征方面无差异。两组在围产期结局方面，包括自然早产、胎盘异常、出生体重和分娩时的孕周，均无差异。
与刚分娩且无既往堕胎史的青少年女性相比，刚分娩且有既往堕胎史的女性首次怀孕时年龄更大，更有可能更早开始产前检查。因此，既往有堕胎史可能会改善孕期健康，尽管两组的不良结局并无差异。
