General Obstetrics and Gynecology Obstetrics
A history of induced abortion in relation to substance use during subsequent pregnancies carried to term

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Abstract

Objective: Previous research has revealed a general association between induced abortion and substance use. The purpose of this study was to examine the correlation when substance use is measured specifically during a subsequent pregnancy. Study Design: A nationally representative sample of women was surveyed about substance use during pregnancy shortly after giving birth. Women with a previous induced abortion, whose second pregnancy was delivered, were compared separately with women with one previous birth and with women with no previous births. Results: Compared with women who gave birth, women who had had an induced abortion were significantly more likely to use marijuana (odds ratio, 10.29; 95% CI, 3.47-30.56), various illicit drugs (odds ratio, 5.60; 95% CI, 2.39-13.10), and alcohol (odds ratio, 2.22; 95% CI, 1.31-3.76) during their next pregnancy. The results with only first-time mothers were very similar. Conclusion: Psychosocial mechanisms that may explain the findings are discussed. Screening for abortion history may help to identify pregnant women who are at risk for substance use more effectively. (Am J Obstet Gynecol 2002;187:1673-8.)

Section snippets

Material and methods

For the primary analyses, the sample of 607 women was derived from the National Pregnancy and Health Survey completed by 2613 women. This sample was limited to women who had been recently delivered of a child, with either one previous pregnancy with a resolution of an induced abortion (gravida 2, para 1; n = 74) or a live birth (gravida 2, para 2; n = 531) and the necessary background data. Exactly 64.3% of the sample was white (n = 406), 18.4% was Hispanic (n = 116), and 11.4% (n = 72) was

Primary analyses

Chi-square tests, with the calculation of ORs and the η2 statistic, were used to examine the strength of associations between previous reproductive outcome and usage of various substances at any point during pregnancy. The results of these analyses (Table I) indicate significantly higher rates of usage for the induced abortion group (gravida 2, para 1) compared with the birth group (gravida 2, para 2), relative to any form of illicit drug use (marijuana, methadone, heroine, cocaine,

Comment

This study was designed to compare the use of illicit drugs, alcohol, and cigarettes during pregnancy among a nationally representative group of women with either a history of an induced abortion or a live birth. Consistent with previous research,20, 21, 22, 23 the results revealed significantly higher rates of consumption associated with a previous abortion, compared with previous birth relative to the use of any illicit drugs (OR, 5.60; 95% CI, 2.39-13.10) and alcohol (OR, 2.22; 95% CI,

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    Reprint requests: Priscilla Coleman, PhD, Human Development and Family Studies, 16F Family and Consumer Sciences Bldg, Bowling Green State University, Bowling Green, OH 43403. E-mail: [email protected]

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