Previous Induced Terminations
Regarding the aspect of prevention, which is of crucial importance in a scenario of the risk of preterm birth, a relevant and proved association was not mentioned: induced terminations of pregnancies also lead to a higher rate of premature labor and a higher rate of neonates with a low birth weight (1, 2). This is medically plausible since the trauma to the cervix (as the uterus’s attachment and closure mechanism) causes lasting damage. The article mentions as a risk factor “a history of obstetrical problems (previous preterm births or late miscarriages),” but does not mention previous terminations. It is regrettable that this contributing cause of a large number of preterm births (1, 2) was not considered in the primary prevention, because from a medical perspective, this would mean that the large number of preterm babies would be reduced permanently—a favorable outcome for babies from current and subsequent pregnancies.
Dr. med. Michael Kiworr
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Thorp JM Jr, Hartmann KE, Shadigian E: Long-term physical and psychological health consequences of induced abortion: review of the evidence. Obst Gynecol Surv 2002; 58: 67–79. CrossRef MEDLINE|
|2.||Shah PS, Zao J; Knowledge Synthesis Group of Determinants of preterm/LBW births: Induced termination of pregnancy and low birthweight and preterm birth: A systematic review and meta-analyses. BJOG 2009; 116: 1425–42. CrossRef MEDLINE|
|3.||Schleußner E: The prevention, diagnosis and treatment of premature labor. Dtsch Arztebl Int 2013; 110(13): 227–36. VOLLTEXT|