It has been suggested that abortions leave the breast epithelium in a proliferative state with an increased susceptibility to carcinogenesis. Results from previous studies of induced or spontaneous abortions and risk of subsequent breast cancer are contradictory, probably due to methodological considerations. We investigated the relationship between abortions and subsequent breast cancer risk in a case-control study using prospectively recorded exposure information. The study population comprised women recorded in the population-based Swedish Medical Birth Register between 1973-91. Cases were defined by linkage of the birth register to the Swedish Cancer Register and controls were randomly selected from the birth register. From the subjects' antenatal care records we abstracted prospectively collected information on induced and spontaneous abortions, as well as a number of potential confounding factors. Relative risk of breast cancer was estimated by odds ratios (OR) with 95% confidence intervals (95% CI). A reduced risk of breast cancer was observed for women with a history of at least 1 compared to no abortions (adjusted OR = 0.84, 95% CI = 0.72-0.99). The adjusted OR decreases step-wise with number of abortions to 0.59 (95% CI = 0.34-1.03) for 3 or more compared to no abortions. The patterns are similar for induced and spontaneous abortions. In conclusion, neither a history of induced nor spontaneous abortions is associated with an increased risk of breast cancer. Our data suggest a protective effect of pregnancies regardless of outcome.
Comment In: Int J Cancer. 2004 May 10;109(6):945-6; author reply 947-815027130
A study is presented of 283 women aged 14-47 who had abortions, with emphasis on contraceptive methods used at conception and complications of the abortion. 28% of the women were under 20 years of age, and 45% were nulliparae. 76% of the abortions were performed by vacuum aspiration, with a complication frequency of 9%. Extraamniotic salt water instillation was performed in 18% of the cases, with 43% of the patients experiencing complications. Intraamniotic salt water instillation was performed with 6% of the women, with a 25% complication frequency. These complication figures are comparable to other studies. The lack of reliable contraceptive protection at the time of conception is discussed. Approximately 33% of the women had used no form of contraceptive, and approximately 33% had used the condom as the only means of contraception. It is considered very important to make contraceptive information more available so contraceptive methods are used more often.
Is the perinatal health of first-born children affected by the mother's previous induced abortion(s) (IAs)?
Prior IAs, particularly repeat IAs, are correlated with an increased risk of some health problems at first birth; even in a country with good health care quality.
A positive association between IA and risk of preterm birth or a dose-response effect has been found in some previous studies. Limited information and conflicting results on other infant outcomes are available.
Nationwide register-based study including 300 858 first-time mothers during 1996-2008 in Finland.
All the first-time mothers with a singleton birth (obtained from the Medical Birth Register) in the period 1996-2008 (n = 300 858) were linked to the Abortion Register for the period 1983-2008.
Of the first-time mothers, 10.3% (n = 31 083) had one, 1.5% had two and 0.3% had three or more IAs. Most IAs were surgical (88%) performed before 12 weeks (91%) and carried out for social reasons (97%). After adjustment, perinatal deaths and very preterm birth (
Induced abortion rates have remained stable in Canada for the last ten years, while, in Quebec, they have been on the rise since 1970. This descriptive study was performed in a family planning clinic in Quebec City where induced abortion is available on demand until 16 weeks of gestational age and was obtained by 2,829 women over a period of 20 months during 1988-90. These women were mostly young unmarried and well educated; being at school or in the workforce, they used abortion to postpone childbearing. This study underlines the need for a better understanding of the determinants of both induced abortion and contraceptive use and of the psychosocial aspects of induced abortion.
On July 19, 2005, the Food and Drug Administration (FDA) issued a public health advisory regarding the deaths of four women in the United States after medical abortions with Mifeprex (mifepristone, formerly RU-486; Danco Laboratories, New York, New York) and intravaginal misoprostol. Two of these deaths occurred in 2003, one in 2004, and one in 2005. Two of these U.S. cases had clinical illness consistent with toxic shock and had evidence of endometrial infection with Clostridium sordellii, a gram-positive, toxin-forming anaerobic bacteria. In addition, a fatal case of C. sordellii toxic shock syndrome after medical abortion with mifepristone and misoprostol was reported in 2001, in Canada. All three cases of C. sordellii infection were notable for lack of fever, and all had refractory hypotension, multiple effusions, hemoconcentration, and a profound leukocytosis. C. sordellii previously has been described as a cause of pregnancy-associated toxic shock syndrome.