Pregnancy is a condition with a finite number of outcomes, including birth, abortion,
and pregnancy loss. Existing studies describe seasonality trends for birth and abortion,
but no studies assess relationships between birthing volumes and surgical abortion
or surgically managed early pregnancy loss (SEPL) volumes. To evaluate relationships
between obstetric outcomes, we designed this retrospective review of birth, abortion,
and SEPL volumes at our medical center.
This retrospective ecological study utilized CPT billing codes to detail birth, abortion,
and SEPL volumes at Vanderbilt University Medical Center from 2011 to 2019. Abortion
and miscarriage cases were validated by individual chart review by the study team.
Data were plotted on line and bar graphs to evaluate changes over time and relationships
A total of 50,472 obstetric outcomes occurred in the study period. Proportions of
White and Black patients were similar in the birth and composite abortion SEPL outcomes
(68.2% vs. 71.6%; 15.5% vs. 17.4%). Both birth and surgical abortion volumes per year
essentially doubled (3,511 to 6,573, 13–29); SEPL volume increased by a factor of
2.6 (115–268). The proportions of abortions and SEPL outcomes remained constant throughout
the study period (0.4% and 3.4%).
As birthing volumes increase, so do abortion and SEPL volumes. Outcome proportions
remained stable over time; these proportions can be used to estimate future abortion
and SEPL volumes based on anticipated delivery volumes. When increasing delivery volumes,
medical centers must prepare for increases in patients experiencing the breadth of