Teen Pregnancy: Are Pregnancies following an Elective Termination Associated with Increased Risk for Adverse Perinatal Outcomes?
OBJECTIVE
The authors sought to determine whether pregnancies in adolescents following an abortion of pregnancy is associated with an elevated risk for adverse perinatal outcomes.


METHODS
In a cohort study of all adolescent (younger than 18 years) deliveries over a 4-year period at 1 institution, we compared nulliparous women with a history of a prior abortion (cases) to those without a spontaneous loss or abortion of pregnancy (referent) for adverse perinatal outcomes, including preterm birth and fetal growth restriction.


RESULTS
Of the 654 included nulliparous adolescent deliveries, 102 (16%) had an abortion before the index pregnancy. Compared with the referent group, adolescents with a history of a abortion were older (17.8 ± 0.8 vs 16.7 ± 1.2 years, P = .0001), enrolled earlier for prenatal care (14.4 ± 5.6 vs 17.2 ± 7.6 weeks, P = .0004), along with a higher incidence of African American race (95% vs 88%, P = .05). The groups did not differ with respect to other maternal demographics. Perinatal outcomes, including spontaneous preterm birth, abnormal placentation, birth weight, and gestational age at delivery, did not differ between the 2 groups.


CONCLUSIONS
Compared with adolescent women who had just delivered and did not have a prior abortion, women who had just delivered and had a previous abortion were more likely to be older at the age of their first pregnancy and more likely to initiate early prenatal care. Thus, having a prior abortion may improve the health of a pregnancy though adverse outcomes do not differ between the 2 groups.
Department of Obstetrics and Gynecology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. Electronic address: teelkien@gmail.com.
Teelkien R
TR
van Veen
St. David's Women's Center of Texas, Austin Maternal-Fetal Medicine, Austin, Texas.
Sina
S
Haeri
Mercer School of Medicine, Memorial Health University Medical Center, Savannah, Georgia.
Arthur M
AM
Baker
D000028:Abortion, Induced / Q000009:adverse effects*; D000022:Abortion, Spontaneous / Q000209:etiology; D000293:Adolescent; D000367:Age Factors; D001724:Birth Weight; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D011253:Pregnancy in Adolescence / Q000706:statistics & numerical data*; D047928:Premature Birth / Q000209:etiology; D011295:Prenatal Care / Q000706:statistics & numerical data; D012307:Risk Factors; D055815:Young Adult
Abortion; Prenatal care; Teenagers