Dongguan Maternal and Child Health Care Hospital, China.
J Matern Fetal Neonatal Med. 2023 Dec;36(1):2207114. doi: 10.1080/14767058.2023.2207114.
To explore the relationship between a history of induced abortion and follow-up preterm birth.
We performed a retrospective cohort study of 27,176 women aged 19 to 48 years old in the city of Dongguan. Participants were divided into two groups according to the history of induced abortion. We used log-binomial regression to estimate adjusted risk ratios of preterm birth (gestation at less than 37 weeks) and early preterm birth (gestation at less than 34 weeks) for women with a history of induced abortion. Four models adjusted for different baseline data were used to verify the stability of the results. We also performed a subgroup analysis and mediation effect analysis to control for the influence of confounding factors and analyzed the relationship between the number of abortions and subsequent preterm birth.
Our study included 2,985 women who had undergone a prior induced abortion. Women who reported having a prior induced abortion were more likely to have preterm births before 37 weeks and 34 weeks, with risk ratios of 1.18 (95% CI 1.02-1.36) and 1.65 (95% CI 1.23-2.21), respectively. The above associations were stable in all models. We also found that a history of induced abortion was independently associated with a higher risk of preterm birth and early preterm birth in the subgroups. After controlling for the indirect effect of demographic data, the direct effect of abortion history on follow-up preterm delivery was still significantly different. The higher the number of abortions, the greater the risk of subsequent preterm birth.
This study suggests that induced abortion increases the risk of subsequent preterm birth.
探讨人工流产史与早产随访之间的关系。
我们对东莞市 27176 名年龄在 19 至 48 岁的妇女进行了回顾性队列研究。参与者根据人工流产史分为两组。我们使用对数二项式回归估计人工流产史妇女早产（妊娠 37 周以下）和早期早产（妊娠 34 周以下）的校正风险比。使用四个不同基线数据调整的模型来验证结果的稳定性。我们还进行了亚组分析和中介效应分析，以控制混杂因素的影响，并分析了流产次数与随后早产之间的关系。
我们的研究包括 2985 名曾接受过人工流产的妇女。报告有过人工流产史的妇女更有可能在妊娠 37 周和 34 周前发生早产，风险比分别为 1.18（95%CI 1.02-1.36）和 1.65（95%CI 1.23-2.21）。所有模型均显示上述关联稳定。我们还发现，人工流产史与早产和早期早产的风险增加在亚组中独立相关。在控制人口统计学数据的间接效应后，流产史对后续早产的直接效应仍然存在显著差异。流产次数越高，随后早产的风险越大。
本研究表明人工流产会增加随后早产的风险。
