Risk of preterm birth and peripartal complications after first trimester termination of pregnancy: a retrospective cohort study of 35,897 singleton births
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Purpose
The objective of this study was to explore whether a history of termination of pregnancy (TOP) in births after 2015 in a high income setting is still linked to preterm birth (PTB) and peripartal complications.
Methods
35,897 singleton births from a perinatal center with approximately 5000 births per year between 2015 and 2022 were analyzed. Patients with a history of first trimester TOP (TOP < 15 weeks) were compared to those who had never had a TOP. A two-step statistical approach using Chi-squared analysis and forward-step multiple logistic regression was used to explore the relationship.
Results
4132 individuals (11.51%) had a history of first trimester TOP. Our findings suggest an association between past TOP and a higher risk for PTB (OR = 1.44, 95% CI [1.25–1.67], p < 0.001). This increases with the number of TOP, six or more TOP were associated with the highest odds ratio for spontaneous PTB (OR = 5.21, 95% CI [1.88–14.46], p = 0.002). The risk for PTB did not differ between methods. Furthermore, our data suggest an association between past TOP and placental retention (OR = 1.25, 95% CI [1.03–1.52], p = 0.022).
Conclusion
These findings underscore the importance of still recognizing prior TOP as a risk factor in obstetric care. The results may inform targeted counseling and the development of preventative strategies to mitigate maternal and fetal morbidity.
