Abstract
Background
The rate of repeat induced abortion varies from 30% to 38% in northern Europe. Thus,
repeat abortion is an important public health issue. However, risk factors as regards
repeat abortion are poorly understood. We characterized risk factors related to sociodemographic
characteristics, history of abortion and post-abortal contraception.
Study design
A prospective cohort study of 1269 women undergoing medical abortion between August
2000 and December 2002 was conducted. The subjects were followed via the Finnish Registry
of Induced Abortions until December 2005, the follow-up time (mean��SD) being 49.2��8.0
months.
Results
Altogether, 179 (14.1%) of the subjects requested repeat abortion within the follow-up
time. In univariate analysis, a history of prior abortion, being parous, young age,
smoking and failure to attend the follow-up visit were associated with repeat abortion.
Immediate ��� in contrast to postponed ��� initiation of any contraceptive method
was linked to a lower risk of repeat abortion. In comparison with combined oral contraceptives,
use of intrauterine contraception was most efficacious in reducing the risk of another
pregnancy termination. In multivariate analysis, the effects of young age, being parous,
smoking, a history of prior abortion and type of contraception on the risk of another
abortion persisted.
Conclusions
An increased focus on young women, parous women and those with a history of abortion
may be efficacious in decreasing repeat abortion. Contraceptive choices made at the
time of abortion have an important effect on the rate of repeat abortion. Use of intrauterine
contraceptives for post-abortal contraception was associated with decreased risk of
repeat abortion.
Keywords
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Article info
Publication history
Published online: May 28, 2008
Accepted:
March 13,
2008
Received in revised form:
February 26,
2008
Received:
January 18,
2008
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
