LETTER REFERENCES
Letter on post-abortion problems
Dear Dave Beery (Daily Herald),
Hi. In a recent article you quoted Carolyn H. Krause who voted against an Illinois Parental Notification bill as saying: "we decided to vote to protect the young woman and concurred with the majority". Some protection!!! According to the 7 December 1996 British Medical Journal, Finnish women who chose to 'terminate' had 488% higher relative risk of suicide in the 12 months after compared to women who carried to term. A 1997 study in the top Scandinavian journal in the area of obstetrics and gynecology reported that women who 'terminated' had four (4) times the odds of dying in an accident in the 12 months after than women who carried to term. What is the top killer of young people between the ages of 15 and 24? Motor vehicle ACCIDENTS. So, Krause's concept of 'protection' is akin to the protection of hens by foxes. In the 17 February 2001 British Medical Journal is my letter where I cited ten studies finding that prior induced abortions much increase a woman's risk of a future preterm birth (please see the Appendix to this email for a copy of that BMJ letter); I now have a list of over twenty-six studies finding preterm risk. 'Preemies' are at much higher risk of dying before age one and having severe handicaps than full-term normal weight newborn. If Carolyn H. Krause is offering 'protection' to young women, then she is the sort who also probably thinks that sky-diving without a parachute is the epitome of safety.
Womens' Right To Know, Brent Rooney Appendix: British Medical Journal letter to the editor
[British Medical Journal. Having an induced abortion increases risk in future pregnancies. 17 February 2001;322:430]
Editor-- The latest of three Danish reports about reproductive history informs readers, "Fetal loss is high in women in their late 30s or older, irrespect- ive of reproductive history. This should be taken into consideration in pregnancy planning and counsel- ling."(1)
Consider a woman whose first pregnancy occurs at age 30. According to Melbye et al and Zhou et al, if she is pressured to have an induced abortion she should be warned that if she does so she will increase her risk of never having a birth.(2,3) Will the abortion clinic tell her that her best chance for a full-term birth is for her to carry her current pregnancy to term? No, it will not; no abortion clinic's consent form mentions such a risk. Even if a woman does have a future birth, a previous induced abortion about doubles her risk that that birth will be very preterm (less than 34 weeks' gestation) according to another study of Danish women (relative risk 1.99 (95% confidence interval 1.64 to 2.43)).(3) If the woman has two evacuation type abortions, she increases her risk of preterm birth by 1155% (5.14 to 30.64).(3) There are at least nine other reports that found increased risk of prematurity from previous induced abortions.(4-5) (readers can visit www.vcn.bc.ca/~whatsup for references to 10 studies known to me)
By not informing prospective patients of health risks associated with induced abortion, abortion doctors are violating their legal duty to protect health, not needlessly endanger it. Is there any serious health risk for a mother who has a preterm birth? In their study of Danish women Melbye et al inform us that if the gestation of a newborn infant is under 32 weeks, the mother has doubled her risk of breast cancer compared with having a full-term birth (relative risk 2.08 (1.20-3.60) for gestation of 29-31 weeks).(2)
Let's assure that women of reproductive age are fully informed about health risks of medical treat- ments to them and their future children.
Brent Rooney
independent medical researcher
Reduce Preterm Risk Coalition
3456 Dunbar St. (146) Vancouver, Canada V6S 2C2
stopcancer@yahoo.com
1
Andersen A-M N, Wohlfahrt J, Melbye M, et al.
Maternal age and fetal loss: population based register linkage study.
BMJ 2000;320:1708-1712
2
Melbye M, Wohlfahrt J, Andersen A-M N, et al.
Preterm delivery and risk of Breast Cancer.
British J Cancer 1999
80(3/4):609-613
3
Zhou W, Sorenson HT, Olsen H.
Induced Abortion and Subsequent Pregnancy Duration.
Obstetrics & Gynecology
1999;94:948-953
4
Lieberman E, Ryan KJ, Monson RR, Schoenbaum SC.
Risk Factors Accounting For Racial Differences in the rate of premature birth.
NEJM 1987;317: 743-748
5
Berkowitz GS.
An Epidemiologic Study of Preterm Delivery.
American J Epidemiology 1981;113:81-92
[end of letter to British Medical Journal]
Additional References not in the original BMJ article (since there was a limit of FIVE references for letters): seven more studies that reported increased risk of preterm birth from previous induced abortions.
6
Pickering RM, Forbes J.
Risk of preterm delivery and small-for-gestational age infants following
abortion: a population study.
British J Obstetrics and Gynecology
1985;92:1106-1112
7*Michielutte
R, Ernest JM, Moore ML, Meis PJ, Sharp PC, Wells HB, Buescher PA.
A Comparison of Risk Assessment Models for Term and Preterm Low Birthweight.
Preventive Medicine
1992;21:98-109
8
Lang JM, Lieberman E, Cohen A.
A Comparison of Risk Factors for Preterm Labor and Term
Small-for-Gestational-Age Birth.
Epidemiology
1996;7:369-376
9
Mueller-Heubach E, Guzick DS.
Evaluation of risk scoring in a preterm birth prevention study of indigent
patients.
Am J Obstetrics & Gyn
1989;160:829-837
10 Shiono PH, Lebanoff MA.
Ethnic Differences and Very Preterm Delivery.
Am J Public Health
1986;76:1317-1321
11 Pantelakis SN,
Papadimitriou GC, Doxiadis SA.
Influence of induced and spontaneous abortions on the outcome of subsequent
pregnancies.
Amer J Obstet Gynecol.
1973;116:799-805
12 Lumley J.
The association between prior spontaneous abortion, prior induced abortion and
preterm birth in first singleton births.
Prenat Neonat Med
1998;3:21-24.
[The above letter to the British Medical Journal was sent in the Summer of 2000. In the mean time I have found SEVENTEEN (17) more statistically significant studies that report that previous induced abortions increase the risk of a subsequent preterm birth. Thus, the total of such studies is TWENTY-SEVEN (27)]
13 Van Der Slikke JW,
Treffers PE.
Influence of induced abortion on gestational duration in subsequent pregnancies.
BMJ 1978;1:270-272 [>95% confident of preterm risk for gestation
less than 32 weeks]
14 Richardson JA, Dixon G.
Effect of legal termination on subsequent pregnancy.
British Med J
1976;1:1303-1304
15 Pickering RM, Deeks JJ.
Risks of Delivery during 20th to the 36th Week of Gestation.
Intl. J Epidemiology
1991;20:456-466
16 Koller O, Eikhom SN.
Late Sequelae of Induced Abortion in Primigravidae.
Acta Obstet Gynecol Scand
1977;56:311-317
17 Papaevangelou G,
Vrettos AS, Papadatos D, Alexiou C.
The Effect of Spontaneous and Induced Abortion on Prematurity and Birthweight.
The J Obstetrics and Gynaecology of the British Commonwealth.
May 1973;80:418-422
18 Bognar Z, Czeizel A.
Mortality and Morbidity Associated with Legal Abortions in Hungary,
1960-1973.
AJPH
1976;66:568-575
19 Martius JA, Steck T,
Oehler MK, Wulf K-H.
Risk factors associated with preterm (<37+0 weeks) and early preterm
(<32+0 weeks): univariate and multivariate analysis of 106 345 singleton
births from 1994 statewide perinatal survey of Bavaria.
European J Obstetrics & Gynecology
Reproductive Biology
1998;80:183-189
20 Vasso L-K, Chryssa T-B,
Golding J.
Previous obstetric history and subsequent preterm delivery in Greece.
European J Obstetrics & Gynecology
Reproductive Biology
1990;37:99-109
21*Ancel P-V,
Saurel-Cubizolles M-J, Renzo GCD, Papiernik E, Breart G.
Very and moderate preterm births: are the risk factors different?
British J Obtetrics and Gynaecology
1999;106:1162-1170
22 Lumley J.
The epidemiology of preterm birth.
Bailliere's Clin Obstet Gynecology.
1993;7(3): 477-498
23 Grindel B, Lubinski H,
Voigt M.
Induced abortion in primigravidae and subsequent pregnancy, with particular
attention of underweight.
Zentralbl Gynaekol
1979;101:1009-1114
24 Kreibich H, Ludwig A.
Early and late complications of abortion in juvenile primigravidae (including
recommended measures).
Z Aerztl Fortbild (Jena)
1980;74:311-316
25 Zwahr C, Voigt M, Kunz
L, et al.
Relationships between interruption abortion, and premature birth and low birth
weight.
Zentrabl Gynaekol
1980;102: 738-747
26 Obel E.
Pregnancy Complications Following Legally Induced Abortion With Special
Reference to Abortion Technique.
Acta Obstet Gynecol Scand
1979;58:147-152
27 Levin A, Schoenbaum S,
Monson R, Stubblefield P, Ryan K.
Association of Abortion With Subsequent Pregnancy Loss.
JAMA
1980;243(24):2495-2499
28*Hillier SL, Nugent RP,
Eschenbach DA, Krohn MA, et al.
Association Between Bacterial Vaginosis And Preterm Delivery Of A
Low-Birth-Weight Infant.
NEJM
1995;333:1737-1742
29 Schoenbaum LS, Monson
RR.
No association between coffee consumption and adverse outcomes of pregnancy.
NEJM
1982;306:141-145
.............................................................
* studies that did not distinguish between induced and spontaneous abortions