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Preterm Birth Update
1American College of Obstetricians and Gynecologists and the American College of Surgeons, and Department of Obstetrics and Gynecology at West Virginia University.
Insights
Induced abortions before first pregnancy increase preterm birth risk. Multiple abortions significantly elevate this risk, demonstrating a dose-related effect and substantial associated healthcare costs.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Epidemiology
Background:
- Preterm birth and low birth weight are significant global health issues, causing millions of deaths and disability-adjusted life years annually.
- The low birth weight delivery rate in the U.S. has been rising, reaching a 30-year high in 2002.
- Previous research suggests a link between abortion history and preterm birth risk.
Purpose of the Study:
- To analyze the association between induced abortions prior to first pregnancy and the risk of preterm birth.
- To investigate the dose-related effect of abortion history on preterm birth rates.
- To estimate the economic impact of abortion-related prematurity on healthcare costs.
Main Methods:
- A meta-analysis of studies examining abortion and preterm birth was reviewed.
- Odds ratios were calculated to quantify the increased risk of preterm birth associated with abortion history.
- Healthcare costs associated with prematurity were estimated.
Main Results:
- A history of one induced abortion was associated with a 35% increased risk of preterm birth (OR 1.35).
- More than two induced abortions increased preterm birth risk by 72% (OR 1.72), indicating a dose-response relationship.
- Annual U.S. hospitalization costs for prematurity linked to abortion exceed $1.2 billion.
Conclusions:
- Induced abortions prior to first pregnancy are associated with a significantly increased risk of preterm birth.
- The risk of preterm birth escalates with an increasing number of prior induced abortions.
- Abortion-related prematurity imposes a substantial financial burden on the U.S. healthcare system.
Abstract:
Preterm birth plagues modern society, with over three million deaths worldwide annually. When combined with low birth weight, preterm births are estimated to cost over one hundred million disability-adjusted life years. In the U.S., the low birth weight (newborn less than 2,500 gms) delivery rate in 2002 increased to 7.8 percent from 6.8 percent in 1985. This marks the highest rate in over thirty years. A large meta-analysis from 2009 analyzing abortion and preterm birth found an increased risk for preterm birth with an odds ratio of 1.35 (95 percent CI 1.20-1.52) for preterm demonstrating a 35 percent increase in the preterm birth rate in patients with only one abortion. The odds ratio for preterm birth for greater than two induced abortions was 1.72 (95 percent CI 1.45-2.04) demonstrating a 72 percent increase in the preterm birth rate and the important epidemiological principle of a dose-related effect: The more abortions one has prior to first pregnancy, the higher the risk for preterm birth. Finally, it is estimated that the concomitant expense due to prematurity from abortion may cost well over $1.2 billion per year in the U.S. in hospitalization (neonatal intensive care unit) costs alone.
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