Previous Induced Terminations

The Prevention, Diagnosis, and Treatment of Premature Labor by Prof. Dr. med. Ekkehard Schleußner in volume 13/2013

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.

DOI: 10.3238/arztebl.2013.0559a

Dr. med. Michael Kiworr

Mannheim

Conflict of interest statement

The author declares that no conflict of interest exists.

References

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.

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.

3. Schleußner E: The prevention, diagnosis and treatment of premature labor. Dtsch Arztebl Int 2013; 110(13): 227–36.