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The effect of method and gestational age at termination of pregnancy on future obstetric and perinatal outcomes: a register‐based cohort study in A berdeen, S cotland
Author(s) -
Woolner A,
Bhattacharya S,
Bhattacharya Soh
Publication year - 2014
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.12455
Subject(s) - medicine , pregnancy , odds ratio , obstetrics , gestation , gestational age , confounding , cohort study , confidence interval , population , cohort , logistic regression , gynecology , genetics , environmental health , biology
Objective To determine whether termination of pregnancy ( TOP ), including the method used or gestational age at termination, affects future obstetric and perinatal outcomes. Design Register‐based cohort. Setting Aberdeen Maternity Hospital, S cotland, UK . Population From the Aberdeen Maternity and Neonatal Databank ( AMND ) we identified 3186 women who had terminated their first pregnancy and then had a second pregnancy of beyond 24 weeks of gestation between 1986 and 2010. We identified 42 446 women who had their first delivery in the same time period, for comparison. Methods Univariate and multivariate logistic regression was used to compare outcomes between groups. Complete case analysis with adjustment of confounding factors was carried out, and adjusted odds ratios ( aOR s) with 99% confidence intervals are presented. Main outcome measures The primary outcome was spontaneous preterm delivery ( SPTD ). Results No statistically significant association was found between TOP in the first pregnancy and SPTD in the next pregnancy ( aOR 1.05; 99% CI 0.83–1.32). Neither medical ( aOR 1.03; 99% CI 0.72–1.46) nor surgical ( aOR 1.06; 99% CI 0.78–1.44) termination appeared to affect the risk of spontaneous preterm delivery in the subsequent pregnancy. Late termination (≥13 weeks of gestation) did not appear to increase the risk of spontaneous preterm delivery compared with early termination (<13 weeks of gestation) ( aOR 1.65; 99% CI 0.94–2.92), nor compared with primigravid women ( aOR 1.25; 99% CI 0.97–1.62). There was an associated increased risk of antepartum haemorrhage in the next pregnancy following TOP ( P < 0.01; aOR 1.26; 99% CI 1.10–1.45). Conclusions Evidence on obstetric and perinatal outcomes following TOP remains conflicting. This study suggests that TOP is not associated with an increased risk of spontaneous preterm delivery. Neither the method nor the gestational age of TOP has any effect on this lack of association.