Induced abortion and implications for long-term mental health: a cohort study of 1.2 million pregnancies

IF 3.7 2区医学 Q1 PSYCHIATRY

Journal of psychiatric research Pub Date : 2025-05-16 DOI:10.1016/j.jpsychires.2025.05.031

Nathalie Auger , Jessica Healy-Profitós , Aimina Ayoub , Antoine Lewin , Nancy Low

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引用次数: 0

Abstract

Background

The relationship between induced abortion and long-term mental health is not clear. We assessed whether having an induced abortion was associated with an increase in the long-term risk of mental health hospitalization.

Methods

We carried out a retrospective cohort study of 28,721 induced abortions and 1,228,807 births in hospitals of Quebec, Canada, between 2006 and 2022. The exposure was induced abortion compared with other pregnancies, and the outcome was hospitalization for a psychiatric disorder, substance use disorder, or suicide attempt over time. We followed patients up to 17 years after the end of pregnancy to identify mental health-related hospitalizations. We calculated hazard ratios (HR) and 95 % confidence intervals (CI) for the association between induced abortion and mental health hospitalization, adjusted for pregnancy characteristics.

Results

Rates of mental health-related hospitalization were higher following induced abortions than other pregnancies (104.0 vs. 42.0 per 10,000 person-years). Abortion was associated with hospitalization for psychiatric disorders (HR 1.81, 95 % CI 1.72–1.90), substance use disorders (HR 2.57, 95 % CI 2.41–2.75), and suicide attempts (HR 2.16, 95 % CI 1.91–2.43) compared with other pregnancies. The associations were greater for patients who had preexisting mental illness or were aged less than 25 years at the time of the abortion. Abortion was strongly associated with mental health hospitalization within five years but risks waned over time.

Conclusion

Induced abortion is associated with an increased risk of mental health-related hospitalization in the long term but the association weakens with time.

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人工流产及其对长期心理健康的影响：120万例妊娠的队列研究

背景人工流产与长期心理健康之间的关系尚不清楚。我们评估了人工流产是否与精神健康住院的长期风险增加有关。方法对2006年至2022年在加拿大魁北克省医院进行的28,721例人工流产和1,228,807例分娩进行回顾性队列研究。与其他妊娠相比，这种暴露是人工流产，其结果是因精神障碍、物质使用障碍或长期自杀未遂而住院。我们在怀孕结束后对患者进行了长达17年的随访，以确定与精神健康相关的住院情况。我们计算了人工流产与精神健康住院之间的风险比（HR）和95%置信区间（CI），并根据妊娠特征进行了调整。结果人工流产后与精神健康相关的住院率高于其他妊娠（104.0比42.0 / 10000人年）。与其他妊娠相比，流产与精神障碍（HR 1.81, 95% CI 1.72-1.90）、物质使用障碍（HR 2.57, 95% CI 2.41-2.75）和自杀企图（HR 2.16, 95% CI 1.91-2.43）住院相关。这种关联对于先前存在精神疾病或堕胎时年龄小于25岁的患者更大。流产与五年内精神健康住院密切相关，但风险随着时间的推移而减弱。结论人工流产与精神健康相关住院风险长期升高相关，但随时间推移相关性减弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of psychiatric research 医学-精神病学

CiteScore

7.30

自引率

2.10%

发文量

622

审稿时长

130 days

期刊介绍： Founded in 1961 to report on the latest work in psychiatry and cognate disciplines, the Journal of Psychiatric Research is dedicated to innovative and timely studies of four important areas of research: (1) clinical studies of all disciplines relating to psychiatric illness, as well as normal human behaviour, including biochemical, physiological, genetic, environmental, social, psychological and epidemiological factors; (2) basic studies pertaining to psychiatry in such fields as neuropsychopharmacology, neuroendocrinology, electrophysiology, genetics, experimental psychology and epidemiology; (3) the growing application of clinical laboratory techniques in psychiatry, including imagery and spectroscopy of the brain, molecular biology and computer sciences;