Dear Prolife Colleague, The August issue of AJOG has an extremely informative article on preterm birth, an issue that complicates I in 8 pregnancies in the U.S.A. Because of associated morbidity and expense, preterm birth is of intense interest to the medical community. The major author is Jay D. Iams, MD, MFM, Professor and Vice Chair of OSU Dept of ObGyn. (Jay D. Iams, MD; Vincenzo Berghells, MD. Care for women with prior preterm birth. American Journal of Obstetrics & Gynecology. August 2010;203(3):89-100) We certainly commend this article to your study. An Iam’s observation of particular interest is the following:
“Contrary to common belief, population-based studies,[fusion_builder_container hundred_percent=”yes” overflow=”visible”][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][34-36] have found that elective pregnancy terminations in the first and second trimesters are associated with a very small but apparently real increase in the risk of subsequent spontaneous preterm birth (PTB).[37]”
We applaud his statement. Most high profile American writers won’t breathe such a thing. Allow us to mention 2 points in regard to his observation. 1. “contrary to common belief…..’ There are currently 114 studies in the literature all showing a statistically significant association between induced abortion and subsequent preterm birth. And just about none to the contrary. Why then would this association be “contrary to common belief??” Because the association is systematically ignored or severely downplayed by the established authorities in our country. It is not mentioned under complications of induced abortion in any ACOG literature we know of. It is not generally taught. It is denied by default. Maybe that is why it is “contrary to common belief……” Obviously 114 articles should carry some weight, even to the willfully blind. 2. “…terminations….are associated with a very small but apparently real increase in the risk of subsequent spontaneous preterm birth (PTB).” Here he references the 2009 BJOG Shaw article, which found a 1.36 RR (36% increase) for PTB with a previous induced abortion. He calls this a “very small” increase. Remember the WHI study of 2003 that showed a RR of 1.3 for breast cancer in HRT users. 1.3 RR was NOT considered “very small”—in fact, it turned the HRT world upside down, so significant was it deemed to be! But here 1.36 RR Is called “very small” —maybe because induced abortion is the associated culprit? (“See no evil” in induced abortion) Additionally, 50% of women have more than one abortion, and the literature finds the PTB risk ratio for them goes to 1.6 to 1.9., that is a 60% to 90% increase in PTB is subsequent pregnancies Finally, in the abstract, Dr. Iams notes: . “African American women have rates of recurrent preterm birth that are nearly twice that of women of other backgrounds.” He hazards no guess as to why. Africian-American women have an induced abortion rate 3 times that of other American women. Might THAT factor in to the 2X increased rate of PTB?? Perish the thought!! Rather than consider the abortion association, some have even suggested it may be a racial genetic failing in the cervical tissues of African-Americans! (“see no evil”) Prematurity carries certain severe risks. Preemies under 32 weeks have a Cerebral Palsy rates 55 times higher that the rates for a term baby. Ignoring the 114 studies mentioned above (the “blind eye” approach) may not be in the best interest of women considering an induced abortion, or of their subsequent children—would you say?? Jdc/aaplog PS: for a summary of the last 15 years literature on induced abortion and subsequent PTB, go to https://www.aaplog.org/complications-of-induced-abortion/induced-abortion-and-pre-term-birth/ This would be a great project for Resident education. Simply have them evaluate the literature. (It seems better than the “see no evil’ approach.) They may even be able to find an article or two that contradicts the finding of the 114 articles mentioned![/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]