French Study Finds Strong Evidence
Abortion Increases Risk of Subsequent Premature
Birth
By Randall K. O'Bannon, Ph.D.
In 2003, when pro-life Ob-Gyn Byron Calhoun and researcher
Brent Rooney published their summary of 49 studies that showed having
an abortion increased the risk of subsequent prematurity in the
Journal of American Physicians and Surgeons1 the world didn't give
the subject much attention. Now, with the publication of a major
study coming out of France in the British Journal of Obstetrics
and Gynecology2 solidly confirming the link between abortion and
subsequent premature births, the evidence and the implications will
be harder to ignore.
The study, titled "Previous induced abortions
and the risk of very preterm delivery: results of the EPIPAGE study,"
covered about one-third of all premature births occurring in France
in 1997. Dr. Caroline Moreau of INSERM, France's National Institute
of Health and Medical Research, and colleagues examined the records
for 1,943 very preterm births (born between 22 and 32 weeks), 276
moderately preterm births (born at 33-34 weeks), and a comparison
group of 618 full-term births.
The conclusion the French research team reached is
that women with a history of induced abortion had a 50% higher risk
of having a very preterm delivery than women who had not aborted.
The risk was 70% higher for delivering a baby at 22 to 27 weeks
gestation, a category which researchers call "extremely preterm
deliveries." (This can be confusing unless you understand that
the "extremely preterm birth" category is a subset of
the larger "very preterm birth" category: 22-32 weeks.)
The idea that abortion might have an impact on future
pregnancies is logical enough. Abortion involves not simply the
destruction of the unborn child, but an aggressive assault on the
woman's reproductive organs.
Any injury, even if undetectable at the time of the abortion, might
have consequences when that woman becomes pregnant in the future.
In other words, more than one child may die from the original abortion.
Results were even more striking when researchers looked at the association
between abortion and specific causes of subsequent very preterm
delivery (22-32 weeks).
There was no observable connection between having
an abortion and having a subsequent very preterm delivery that is
due to high blood pressure, a common cause of prematurity. However,
there was a substantial increased risk of premature birth causes
that could conceivably be tied to infections or injuries brought
on by what the authors refer to as the "mechanical processes"
of abortion.
For example, the study showed a 40% increased risk
of a very premature birth (22-32 weeks) caused by placental abruption
(separation of the placenta from the uterine wall, accompanied by
hemorrhage) and 140% increased risk of very premature birth tied
to placenta previa (in which the pregnancy implants low in the uterus,
partially or completely covering the cervical opening, which can
involve bleeding in the third trimester).
The increased risk of subsequent extremely preterm
births (22 to 27 weeks) for women who have had an abortion was even
greater. Risk of placental abruption in these cases was 50% greater,
while the risk of placenta previa was 310% higher!
There were also significant increases in risk (70%-120%)
associated with other common causes of preterm birth, such as fetal
growth restriction, prematurely ruptured membranes, and the early
onset of labor.
The significance of these findings cannot be overstated. Babies
have survived and thrived even when born as early as 22 or 23 weeks
old, but generally speaking, the earlier the baby is born, the greater
the risk to the life and health of both mother and child.
The researchers say that their findings, along with
those of similar studies, "all suggest that induced abortion
could produce cervical and uterine abnormalities, responsible for
an increased risk of subsequent preterm delivery."
It has been speculated elsewhere that damage to the
endometrium during aggressive curettage may prevent the embryo from
implanting in its normal place in the upper uterine wall, leading
to placenta previa or placental abruption.
Researchers speculate that forced or mechanical dilation
of the cervix in abortion may lead to cervical incompetence (so
that the uterus fails to hold the child in place), which may increase
the risk of upper genital tract infections. Generally, the authors
say, abortion may bring about the "revival of local infections
processes caused by surgery," itself believed to be a risk
factor for premature rupture of the membranes.
Pro-lifers have long made the point that every abortion has at least
two victims - - the innocent child, who loses his or her life, and
the mother, who is often emotionally scarred and possibly physically
damaged. This new evidence demonstrates that abortion may not only
claim those immediate victims, but may reach into the future to
strike a woman's later offspring.
Turns out that Calhoun and Rooney were really onto
something after all.
Randall K. Bannon. Ph.D., is director
of Research and Education for the National Right to Life Trust Fund.
This article first appeared in the May 2005 issue of the National
Right to Life News. Reprinted with permission.
NOTES:
1. See our report "Abortion Linked to Subsequent Premature
Births" on Calhoun and Rooney's article in the July 2003 NRL
News.
2. Caroline Moreau, et al., "Previous induced abortions and
the risk of very preterm delivery: results of the EPIPAGE study,"
British Journal of Obstetrics and Gynecology, 112 (April 2005):
430-37.
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