Dose Effect: Difference between revisions
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===Dose Effect Evidence=== | ===Dose Effect Evidence=== | ||
==== | ====Mental Health Dose Effect==== | ||
'''[http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13233/full Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy.] McCarthy F, Moss-Morris R, Khashan A, et al.BJOG An Int J Obstet Gynaecol. 2015;122(13):1757-1764. doi:10.1111/1471-0528.13233.''' | '''[http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.13233/full Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy.] McCarthy F, Moss-Morris R, Khashan A, et al.BJOG An Int J Obstet Gynaecol. 2015;122(13):1757-1764. doi:10.1111/1471-0528.13233.''' | ||
:Women with one previous termination displayed elevated perceived stress (adjusted mean difference 0.65; 95% CI 0.08–1.23) and depression (aOR 1.25; 95% 1.08–1.45) at 15 weeks of gestation. Women with two previous terminations displayed increased perceived stress (adjusted mean difference 1.43; 95% CI 0.00–2.87) and depression (aOR 1.67; 95% 1.28–2.18). | :Women with one previous termination displayed elevated perceived stress (adjusted mean difference 0.65; 95% CI 0.08–1.23) and depression (aOR 1.25; 95% 1.08–1.45) at 15 weeks of gestation. Women with two previous terminations displayed increased perceived stress (adjusted mean difference 1.43; 95% CI 0.00–2.87) and depression (aOR 1.67; 95% 1.28–2.18). | ||
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==== | ====Physical Health Dose Effect==== | ||
'''[http://www.ncbi.nlm.nih.gov/pubmed/22933527 Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland.] Klemetti R, Gissler M, Niinimäki M, Hemminki E. Hum Reprod. 2012 Nov;27(11):3315-20. doi: 10.1093/humrep/des294. Epub 2012 Aug 29.''' | '''[http://www.ncbi.nlm.nih.gov/pubmed/22933527 Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland.] Klemetti R, Gissler M, Niinimäki M, Hemminki E. Hum Reprod. 2012 Nov;27(11):3315-20. doi: 10.1093/humrep/des294. Epub 2012 Aug 29.''' | ||
: After adjustment, perinatal deaths and very preterm birth (<28 gestational week) suggested worse outcomes after IA. Increased odds for very preterm birth were seen in all the subgroups and exhibited a dose-response relationship: 1.19 [95% confidence interval (CI) 0.98-1.44] after one IA, 1.69 (1.14-2.51) after two and 2.78 (1.48-5.24) after three IAs. Increased odds for preterm birth (<37 weeks) and low birthweight (<2500 g and <1500 g) were seen only among mothers with three or more IAs: 1.35 (1.07-1.71), 1.43 (1.12-1.84) and 2.25 (1.43-3.52), respectively. | : After adjustment, perinatal deaths and very preterm birth (<28 gestational week) suggested worse outcomes after IA. Increased odds for very preterm birth were seen in all the subgroups and exhibited a dose-response relationship: 1.19 [95% confidence interval (CI) 0.98-1.44] after one IA, 1.69 (1.14-2.51) after two and 2.78 (1.48-5.24) after three IAs. Increased odds for preterm birth (<37 weeks) and low birthweight (<2500 g and <1500 g) were seen only among mothers with three or more IAs: 1.35 (1.07-1.71), 1.43 (1.12-1.84) and 2.25 (1.43-3.52), respectively. | ||
==== | ====Life Expectancy/Elevated Mortality Rate Dose Effect==== | ||
'''[http://www.ncbi.nlm.nih.gov/pubmed/22954474 Reproductive history patterns and long-term mortality rates: a Danish, population-based record linkage study.] Coleman PK, Reardon DC, Calhoun BC. Eur J Public Health. 2012 Sep 5.''' | '''[http://www.ncbi.nlm.nih.gov/pubmed/22954474 Reproductive history patterns and long-term mortality rates: a Danish, population-based record linkage study.] Coleman PK, Reardon DC, Calhoun BC. Eur J Public Health. 2012 Sep 5.''' | ||
:Risk of death was more than six times greater among women who had never been pregnant compared with those who only had birth(s). Increased risks of death were 45%, 114% and 191% for 1, 2 and 3 abortions, respectively, compared with no abortions after controlling for other reproductive outcomes and last pregnancy age. | :Risk of death was more than six times greater among women who had never been pregnant compared with those who only had birth(s). Increased risks of death were 45%, 114% and 191% for 1, 2 and 3 abortions, respectively, compared with no abortions after controlling for other reproductive outcomes and last pregnancy age. | ||
Revision as of 16:27, 8 December 2016
Dose Effect Evidence
Mental Health Dose Effect
Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy. McCarthy F, Moss-Morris R, Khashan A, et al.BJOG An Int J Obstet Gynaecol. 2015;122(13):1757-1764. doi:10.1111/1471-0528.13233.
- Women with one previous termination displayed elevated perceived stress (adjusted mean difference 0.65; 95% CI 0.08–1.23) and depression (aOR 1.25; 95% 1.08–1.45) at 15 weeks of gestation. Women with two previous terminations displayed increased perceived stress (adjusted mean difference 1.43; 95% CI 0.00–2.87) and depression (aOR 1.67; 95% 1.28–2.18).
Depression Following Induced Abortion. Koyun, A., Kır Şahin, F., Çevrioğlu, S., Demirel, R., & Geçici, Ö. (2016). Gynecology Obstetrics & Reproductive Medicine, 13(2). doi:http://dx.doi.org/10.21613/GORM.2007.521
- Note. The researchers also observed a dose effect, with multiple abortions increasing depression risk.
Increased risk for postpartum psychiatric disorders among women with past pregnancy loss. Giannandrea SAM, Cerulli C, Anson E, Chaudron LH. J Womens Health (Larchmt) [Internet]. 2013;22(9):760–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/24007380 PMID: 24007380
- Multiple losses, either from miscarriage or induced abortion, predict elevated rates of postpartum anxiety.(2)
Physical Health Dose Effect
Birth outcomes after induced abortion: a nationwide register-based study of first births in Finland. Klemetti R, Gissler M, Niinimäki M, Hemminki E. Hum Reprod. 2012 Nov;27(11):3315-20. doi: 10.1093/humrep/des294. Epub 2012 Aug 29.
- After adjustment, perinatal deaths and very preterm birth (<28 gestational week) suggested worse outcomes after IA. Increased odds for very preterm birth were seen in all the subgroups and exhibited a dose-response relationship: 1.19 [95% confidence interval (CI) 0.98-1.44] after one IA, 1.69 (1.14-2.51) after two and 2.78 (1.48-5.24) after three IAs. Increased odds for preterm birth (<37 weeks) and low birthweight (<2500 g and <1500 g) were seen only among mothers with three or more IAs: 1.35 (1.07-1.71), 1.43 (1.12-1.84) and 2.25 (1.43-3.52), respectively.
Life Expectancy/Elevated Mortality Rate Dose Effect
Reproductive history patterns and long-term mortality rates: a Danish, population-based record linkage study. Coleman PK, Reardon DC, Calhoun BC. Eur J Public Health. 2012 Sep 5.
- Risk of death was more than six times greater among women who had never been pregnant compared with those who only had birth(s). Increased risks of death were 45%, 114% and 191% for 1, 2 and 3 abortions, respectively, compared with no abortions after controlling for other reproductive outcomes and last pregnancy age.