Rates of follow-up and repeat pregnancy in the 12 months after first-trimester induced abortion.
OBJECTIVE
To estimate the proportion of women who returned for a routine follow-up visit after elective abortion and to identify factors associated with repeat pregnancy in the subsequent year.


METHODS
We performed a historical cohort study of 865 women who underwent first-trimester surgical abortion at a hospital-based family planning clinic between March 2003 and February 2004. We collected demographic and clinical data from procedure notes and a computerized hospital patient database. We used univariable and multivariable logistic regression to analyze associations between patient characteristics and repeat pregnancy within 1 year.


RESULTS
There were a total of 865 women in our cohort. Of these, 753 (87%) returned to the medical center for care; 485 women returned on time, 268 women returned late, and 112 had no further visit. There were 161 repeat pregnancies; 87 (17.9%) in the on-time group and 74 (27.6%) in the late group (P<.001). There were 85 repeat abortions; 42 (8.7%) in the on-time group and 43 (16.0%) in the late group (P<.001). Multivariable analysis demonstrated that on-time follow-up was associated with a reduction in repeat pregnancy (odds ratio [OR] 0.54, 95% confidence interval [CI] 0.37-0.77) and repeat abortion (OR 0.53, 95% CI 0.33-0.86). A total of 130 women received injectable depot medroxyprogesterone acetate (DMPA) at the time of abortion. The rates of repeat pregnancy and abortion in these women were 13.7% and 6.2%, respectively. Women who received DMPA had a decrease in rates of repeat pregnancy (OR 0.41, 95% CI 0.23-0.73) and repeat abortion (OR 0.45, 95% CI 0.20-0.99).


CONCLUSIONS
Timely follow-up and immediate administration of DMPA are associated with a decrease in repeat pregnancy in the 12 months after first-trimester elective abortion.
Madden
Tessa
T
From the Washington University School of Medicine, Saint Louis, Missouri; and the Mailman School of Public Health, Columbia University, New York, New York.
Westhoff
Carolyn
C
D000028:Abortion, Induced / Q000706:statistics & numerical data; D000293:Adolescent; D015331:Cohort Studies; D003266:Continuity of Patient Care / Q000706:statistics & numerical data*; D003692:Delayed-Action Preparations; D005260:Female; D006801:Humans; D016015:Logistic Models; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage; D009519:New York City / Q000453:epidemiology; D011247:Pregnancy / Q000706:statistics & numerical data*; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate