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Hum. Reprod. Advance Access published online on December 24, 2008
Human Reproduction, doi:10.1093/humrep/den465
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Can the outcome of the next pregnancy be predicted at the time of induced abortion?

Oskari Heikinheimo1,5, Mika Gissler2,3 and Satu Suhonen4

1 Department of Obstetrics and Gynaecology, University of Helsinki, PO Box 140, SF-00029, HUS, Finland 2 National Research and Development Centre for Welfare and Health, Helsinki, Finland 3 Nordic School of Public Health, Gothenburg, Sweden 4 Sexual Health and Family Planning Clinic, City of Helsinki Health Centre, Helsinki, Finland

5 Correspondence address. Fax: +358-9-47174801; E-mail: oskari.heikinheimo{at}helsinki.fi

BACKGROUND: Factors predicting the outcome of the next pregnancy following termination of pregnancy (TOP) are poorly known.

METHODS: A cohort of 1269 women undergoing medical TOP between 2000 and 2002 were followed up until the next pregnancy or until the end of 2006, using registers of induced abortion, births and hospital discharges. Factors associated with repeat TOP, delivery and failed pregnancy were analysed.

RESULTS: During the mean (±SD) follow-up period of 4.2 ± 1.5 years, 446 (35%) women had at least one subsequent pregnancy. Of these, 207 (46%) resulted in delivery, 169 (38%) in repeat TOP and 16% in failed pregnancy. In multivariate analysis, parity [hazard ratio (HR) 3.42, 95% confidence interval (CI) 1.70–6.91] and history of TOP (HR 1.60, 95% CI 1.10–2.33) were risk factors of repeat TOP. Age above 25 years (HR ≤ 0.46) and the use of intrauterine contraception (HR ≤ 0.45) were associated with reduced risks of repeat TOP. However, only age between 25 and 29 years was associated with an increased probability of delivery (HR 2.44, 95% CI 1.45–4.11).

CONCLUSIONS: Risk factors of repeat TOP are more clearly defined than factors associated with delivery. An increased focus on young women, those with a history of TOP and parous women, might be effective in reducing repeat TOP.

Key words: termination of pregnancy/delivery/pregnancy outcome

Submitted on October 20, 2008; resubmitted on November 27, 2008; accepted on December 3, 2008.


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