title: Comparison of rates of adverse events in adolescent and adult women undergoing medical abortion: population register based study.
abstract: OBJECTIVE
  To determine the risks of short term adverse events in adolescent and older women undergoing medical abortion.
  
  
  METHODS
  Population based retrospective cohort study.
  
  
  METHODS
  Finnish abortion register 2000-6.
  
  
  METHODS
  All women (n = 27,030) undergoing medical abortion during 2000-6, with only the first induced abortion analysed for each woman.
  
  
  METHODS
  Incidence of adverse events (haemorrhage, infection, incomplete abortion, surgical evacuation, psychiatric morbidity, injury, thromboembolic disease, and death) among adolescent (<18 years) and older (≥ 18 years) women through record linkage of Finnish registries and genital Chlamydia trachomatis infections detected concomitantly with abortion and linked with data from the abortion register for 2004-6.
  
  
  RESULTS
  During 2000-6, 3024 adolescents and 24,006 adults underwent at least one medical abortion. The rate of chlamydia infections was higher in the adolescent cohort (5.7% v 3.7%, P < 0.001). The incidence of adverse events among adolescents was similar or lower than that among the adults. The risks of haemorrhage (adjusted odds ratio 0.87, 95% confidence interval 0.77 to 0.99), incomplete abortion (0.69, 0.59 to 0.82), and surgical evacuation (0.78, 0.67 to 0.90) were lower in the adolescent cohort. In subgroup analysis of primigravid women, the risks of incomplete abortion (0.68, 0.56 to 0.81) and surgical evacuation (0.75, 0.64 to 0.88) were lower in the adolescent cohort. In logistic regression, duration of gestation was the most important risk factor for infection, incomplete abortion, and surgical evacuation.
  
  
  CONCLUSIONS
  The incidence of adverse events after medical abortion was similar or lower among adolescents than among older women. Thus, medical abortion seems to be at least as safe in adolescents as it is in adults.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Oulu, Finland.
authors.forename: Maarit
authors.initials: M
authors.lastname: Niinimäki
authors.forename: Satu
authors.initials: S
authors.lastname: Suhonen
authors.forename: Maarit
authors.initials: M
authors.lastname: Mentula
authors.forename: Elina
authors.initials: E
authors.lastname: Hemminki
authors.forename: Oskari
authors.initials: O
authors.lastname: Heikinheimo
authors.forename: Mika
authors.initials: M
authors.lastname: Gissler
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000009:adverse effects*; D000021:Abortifacient Agents, Steroidal / Q000009:adverse effects*; D000027:Abortion, Incomplete / Q000453:epidemiology; D000028:Abortion, Induced / Q000009:adverse effects* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D015994:Incidence; D015735:Mifepristone / Q000009:adverse effects*; D016595:Misoprostol / Q000009:adverse effects*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone