title: Adverse pregnancy outcomes among women with prior spontaneous or induced abortions.
abstract: OBJECTIVE
  The aim of the article is to determine whether prior spontaneous abortion (SAB) or induced abortion (IAB), or the interpregnancy interval are associated with subsequent adverse pregnancy outcomes in nulliparous women.
  
  
  METHODS
  We performed a secondary analysis of data collected from nulliparous women enrolled in a completed trial of vitamins C and E or placebo for preeclampsia prevention. Adjusted odds ratios (ORs) for maternal and fetal outcomes were determined for nulliparous women with prior SABs and IABs as compared with primigravid participants.
  
  
  RESULTS
  Compared with primigravidas, women with one prior SAB were at increased risk for perinatal death (adj. OR, 1.5; 95% CI, 1.1-2.3) in subsequent pregnancies. Two or more SABs were associated with an increased risk for spontaneous preterm birth (PTB) (adj. OR, 2.6, 95% CI, 1.7-4.0), preterm premature rupture of membranes (PROM) (adj. OR, 2.9; 95% CI, 1.6-5.3), and perinatal death (adj. OR, 2.8; 95% CI, 1.5-5.3). Women with one previous IAB had higher rates of spontaneous PTB (adj. OR, 1.4; 95% CI, 1.0-1.9) and preterm PROM (OR, 2.0; 95% CI, 1.4-3.0). An interpregnancy interval less than 6 months after SAB was not associated with adverse outcomes.
  
  
  CONCLUSIONS
  Nulliparous women with a history of SAB or IAB, especially multiple SABs, are at increased risk for adverse pregnancy outcomes.
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas.
authors.forename: Michel A
authors.initials: MA
authors.lastname: Makhlouf
authors.affiliation: The George Washington University Biostatistics Center, Washington, DC.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Clifton
authors.affiliation: Department of Obstetrics and Gynecology University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: James M
authors.initials: JM
authors.lastname: Roberts
authors.affiliation: Department of Obstetrics and Gynecology, University of Cincinnati, Cincinnati, Ohio.
authors.forename: Leslie
authors.initials: L
authors.lastname: Myatt
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: John C
authors.initials: JC
authors.lastname: Hauth
authors.affiliation: Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
authors.affiliation: Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.affiliation: Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.affiliation: Department of Obstetrics and Gynecology, Case Western Reserve University-MetroHealth Medical Center, Cleveland, Ohio.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.affiliation: Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.affiliation: Department of Obstetrics and Gynecology University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.affiliation: Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio.
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.affiliation: Department of Obstetrics and Gynecology, Drexel University, Philadelphia, Pennsylvania.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sciscione
authors.affiliation: Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, Oregon.
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University, Detroit, Michigan.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D000022:Abortion, Spontaneous / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D001721:Birth Intervals; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology*; D020073:Gravidity; D006801:Humans; D007231:Infant, Newborn; D010298:Parity; D066087:Perinatal Death; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult