INDUCED ABORTION AND SPONTANEOUS ABORTION: NO CONNECTION?
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Journal Article INDUCED ABORTION AND SPONTANEOUS ABORTION: NO CONNECTION? Get access JENNIE KLINE, JENNIE KLINE 2 1New York State Psychiatric Institute and Division of Epidemiology, Columbia University School of Public Health 2 Reprint requests to Dr. Kline, School of Public Health, Division of Epidemiology, Columbia University, 600 West 168th St., New York, NY 10032. Search for other works by this author on: Oxford Academic PubMed Google Scholar ZENA STEIN, ZENA STEIN 1New York State Psychiatric Institute and Division of Epidemiology, Columbia University School of Public Health Search for other works by this author on: Oxford Academic PubMed Google Scholar MERVYN SUSSER, MERVYN SUSSER 3Division of Epidemiology, Columbia University School of Public Health and Gertrude H. Sergievsky Center, Columbia University Search for other works by this author on: Oxford Academic PubMed Google Scholar DOROTHY WARBURTON DOROTHY WARBURTON 4Department of Pediatrics and Human Genetics, Columbia University Search for other works by this author on: Oxford Academic PubMed Google Scholar American Journal of Epidemiology, Volume 107, Issue 4, April 1978, Pages 290–298, https://doi.org/10.1093/oxfordjournals.aje.a112544 Published: 01 April 1978 Article history Received: 19 September 1977 Accepted: 06 December 1977 Published: 01 April 1978An epidemiological study of abortion and abortion-related mortality in New York State (exclusive of New York City) shows a pattern of continued decline in mortality over the last 20 years. There is a discussion of maternal mortality associated with the following abortion-connected circumstances: infected spontaneous abortion, spontaneous abortion incidental to primary cause of death, therapeutic abortion, elective abortion, and illegal abortion. Infection was found to be the most important factor associated with abortion-related mortality. Women over 25 died 5 times more often than the teenage group who underwent abortion. Increased length of gestation increased the risk of death. Death from illegal abortion fell substantially after 1970, the year in which a liberalized abortion law was passed in New York.
Abortion law
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A triplet pregnancy is described in which there was a second trimester abortion of one fetus at 16 weeks' gestation. A cervical cerclage was placed, and tocolysis was used. The other two triplets were delivered 131 days later (at 35 weeks' gestation) by cesarean section. Both infants survived. This case is unique in the literature.
Second trimester
Products of conception
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In order to study the effects of abortion on subsequent pregnancy, 13,144 secundigravidae were studied. In 879 of those women the 1st pregnancy had ended in miscarriage, in 820 it ended in abortion, in 25 in tubal pregnancy, in 7 in molar pregnancy, in 294 in premature delivery, and in 11,119 in normal delivery at term. Of the complications of early pregnancy, threatened abortion was the most common. 13.8% of the women who had miscarried previously experienced this complication, as did 9.1% of those who had had an abortion, 9.1% of those who delivered prematurely, and 3.6% of women who experienced normal deliveries. Other complications were equally common in all 4 subgroups. In the 2nd half of pregnancy, miscarriage was about twice as common among women who had had an abortion or miscarriage during their 1st pregnancy as it was in women whose 1st pregnancy was not interrupted. Furthermore, women who had miscarried or aborted the 1st pregnancy were twice as likely as women who delivered at term to give birth to infants weighing less than 2500 gm. Women who had delivered the 1st pregnancy prematurely were about 4 times as likely to have a subsequent premature delivery as were women whose 1st pregnancies ended at term. Thus it appears that interruption of a 1st pregnancy - either by abortion or miscarriage - significantly increases the risk of miscarriage in a subsequent pregnancy.
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Abstract Three hundred and thirty‐nine cases of multiple gestation underwent prenatal diagnosis by amniocentesis. The spontaneous abortion rate (to 28 weeks) in this group was 3.57 per cent compared with our singleton abortion rate of 0.60 per cent. The perinatal mortality rate (PMR) and prematurity rate were not different from the singletons, and compared favourably with the PMR reported in the literature for multiple gestations which did not undergo any intervention during pregnancy. This increased abortion rate following amniocentesis may only represent the increased natural loss rate in multiple gestations, and not indicate any increased risk added by the procedure.
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Confounding may be present in nonrandomized etiological research involving human populations. It can result in erroneous conclusions about the effect of exposure on a disease outcome or about any form of causality between predictors and outcomes. Confounding can wholly or partially account for the apparent effect of the risk factor under consideration or mask the underlying, true association. Not controlling for the effects of confounding can lead to biased results, thus compromising the validity of study conclusions. The three goals of this article are: (1) to define a confounder or a confounding variable, (2) to discuss strategies for controlling the effects of confounding, and (3) to illustrate the perverse effects of confounding with the help of an example.
Causality
Etiology
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Objective:To investigate the distribution and common reason of abortion for hospitalized women in Cangzhou city,provide scientific foundation for the government to take effective measures to decrease the number of induced abortion and to reduce the abortion rate.Methods:It was conducted in 5 hospitals with the method of across-sectional study,parturient question in hospital and the status description of induced abortion.Results:The proportion of induced abortion was 48.5%,the times of induced abortion ranged from 1 to 6.The youngest age for the first time of abortion was 15 years old;the abortion of unmarried women for the first time was 47.39%;the proportion of induced abortion increased with the age of parturient;unintended abortion became the primary reason of induced abortion.Conclusion:It is found that the proportion of induced abortion in Cangzhou is higher,and has the tendency of young and unmarried wemen induded,and the reason for that is complicated.Scientific and effective measures should be taken to reduce induce abortion rate.
Induced Abortions
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Abstract Objective . The aim was to determine the chorionic and amniotic types in multifetal pregnancies with transvaginal ultrasonography at very early stage of gestation. Study design . Twenty-one spontaneous multifetal pregnancies were scanned transvaginally before 8 weeks' gestation (four of them from 4th week). The chorionic and amniotic type was determined ultrasonographically. All twin gestations had postpartum pathologic evaluation of the placenta and histologic determination of the chorionic and amniotic type. Results . Ultrasonographic evaluation of the 21 pregnancies demonstrated 20 twin and 1 triplet gestation. Four of the twin pregnancies were monochorionic-diamniotic. Triplet was monochorionic-triamniotic (spontaneously aborted in 8th week of gestation). In all 20 twin pregnancies, transvaginal ultrasonography correctly predicted the chorionic and amniotic type before 8 weeks of gestation. Conclusion . Transvaginal ultrasonography allows a reliable, simple and rapid determination; the dichorionic twin pregnancy in 4 weeks, monochorionic in 5 weeks, and differentiation of mono-or diamniotic in 7 weeks of gestation.
Transvaginal ultrasonography
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Abstract The first part of this chapter discusses the conditions under which a factor can confound the association between exposure and disease, and the conditions under which this cannot occur. It also differentiates confounders from antecedents or mediators. The next part discusses methods devised to neutralize the effects of confounders. Two standard methods are presented: matching to prevent confounding in the data by equalizing the exposed and the unexposed on a potential confounder, and statistical adjustment to compensate for confounding in the data by separating the effects of the exposure from the effects of the confounder.
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In a prospective study of 500 patients who had an ultrasonically viable pregnancy at less than 12 weeks' gestation, the spontaneous abortion rate was 2% overall. In those women with a history of spontaneous abortion, the abortion rate increased tenfold. Spontaneous abortion at less than ten weeks' gestation was up to three times higher than that at greater than ten weeks' gestation; this may have implications when deciding on the timing of first-trimester diagnostic procedures.
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