首次妊娠流产与随后妊娠结局的持久关联:一项纵向队列研究。

IF 1.5 Q3 HEALTH POLICY & SERVICES
Health Services Research and Managerial Epidemiology Pub Date : 2022-10-11 eCollection Date: 2022-01-01 DOI:10.1177/23333928221130942
James Studnicki, Tessa Longbons, David C Reardon, John W Fisher, Donna J Harrison, Ingrid Skop, Christina A Cirucci, Christopher Craver, Maka Tsulukidze, Zbigniew Ras
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引用次数: 4

摘要

导言:多次堕胎一直与不良健康后果有关。已知先前流产是再次流产的危险因素。目的:确定首次妊娠流产与后续妊娠结局可能性的相关性。方法:从1999-2015年资助和报告选择性堕胎的州的5453名连续合格的医疗补助受益人中提取数据。1999年16岁的妇女根据第一次怀孕的结果分为三组:流产、分娩、自然流产。结果:流产队列中的妇女比出生队列中的妇女更有可能经历另一次流产而不是分娩或自然流产,并且在随后的每次怀孕中,经历活产而不是流产或自然流产的可能性更小。流产倾向(OR = 2.99, CL = 2.02-4.43)和离产倾向(OR = 0.49, CL = 0.39-0.63)在第六次妊娠时达到高峰,但在整个生育期(16-32岁)持续存在。对于出生队列中的女性,这种模式是相反的,但同样是一致的。在随后的怀孕中,她们更有可能再次生育,而不是堕胎或自然流产。与出生队列相比,流产队列的怀孕率是出生队列的1.35倍:流产率为4.31倍,自然流产率为1.53倍,而出生率仅为0.52倍。2 +和3 +流产的可能性分别是女性的4.3倍和5.0倍,但2 +和3 +分娩的可能性分别是女性的0.47倍和0.31倍。在堕胎队列中,37.1%没有生育。相比之下,73.6%的出生队列没有堕胎。结论:首次妊娠流产与随后妊娠再次流产的可能性保持着强烈而持久的关联,从而导致多次流产相关的一系列不良事件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study.

The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study.

The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study.

The Enduring Association of a First Pregnancy Abortion with Subsequent Pregnancy Outcomes: A Longitudinal Cohort Study.

Introduction: Multiple abortions are consistently associated with adverse health consequences. Prior abortion is a known risk factor for another abortion.

Objective: To determine the persistence of the association of a first-pregnancy abortion with the likelihood of subsequent pregnancy outcomes.

Methods: Data was extracted for a study population of 5453 continuously eligible Medicaid beneficiaries in states which funded and reported elective abortions 1999-2015. Women age 16 in 1999 were organized into three cohorts based upon the first pregnancy outcome: abortion, birth, natural loss.

Results: Women in the abortion cohort are more likely than those in the birth cohort to experience another abortion rather than a birth or natural loss, and less likely to experience a live birth rather than an abortion or natural loss, for every subsequent pregnancy. The tendency toward abortion (OR 2.99, CL 2.02-4.43) and away from birth (OR 0.49, CL 0.39-0.63) peaks at the sixth pregnancy, but persists throughout the reproductive period ages 16-32. The pattern is reversed, but similarly consistent, for women in the birth cohort. They remain likelier to have another birth rather than an abortion or natural loss in subsequent pregnancies. Compared to the birth cohort, the abortion cohort had 1.35 times as many pregnancies: 4.31 times the abortions, 1.53 times the natural losses, but only 0.52 times the births. They were 4.3 and 5.0 times as likely to have 2-plus and 3-plus abortions, but only 0.47 times and 0.31 times as likely to have 2-plus and 3-plus births. Of the abortion cohort, 37.1% had no births. By contrast, 73.6% of the birth cohort had no abortions.

Conclusion: The first-pregnancy abortion maintains a strong and persistent association with the likelihood of another abortion in subsequent pregnancies, enabling a cascade of adverse events associated with multiple abortions.

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来源期刊
CiteScore
1.60
自引率
6.20%
发文量
32
审稿时长
12 weeks
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