June 19, 2013 Dear ProLife Colleague, One of the most consistent associations found in the medical literature is the association between induced abortion and increased risk of preterm birth in subsequent pregnancy. Currently, 137 studies confirm this association. Most studies show that one abortion increases the risk of preterm birth by about 30%, and 2 abortions increases the risk by over 70% (and this increasing“dose effect” continues to rise as the number of abortions rise.) A new study from McGill University can be found in the Feb J Obstet Gynaecol Can 2013;35(2):138–143 This can be accessed at: http://www.jogc.com/abstracts/full/201302_Obstetrics_5.pdf The researchers found that, on average, women who had one prior induced abortion were 45% more likely to have premature births by 32 weeks, 71% more likely to have premature births by 28 weeks, and 117% more likely to have premature births by 26 weeks. (aaplog note: This association was stronger with decreasing gestational age, as authors note below) The authors’ conclusion: “Our study showed a significant increase in the risk of preterm delivery in women with a history of previous induced abortion. This association was stronger with decreasing gestational age. This may imply that cervical insufficiency is a part of the mechanism that leads to preterm birth. Women in the reproductive years are often not aware of all the potential short and long-term complications that may arise from an induced abortion… AAPLOG conclusion: “The McGill article is another addition to the weight of evidence that there is a strong and alarming correlation between abortion and subsequent preterm birth. Tremendous effort is expended trying to decrease the heavy burden of preterm birth. The NIH, other federal agencies, many research universities, and the March of Dimes all focus on preterm birth risk factors with one glaring exception – previous abortion. This failure/refusal to connect the dots is a blot on our profession. Informed consent for abortion must include this clear correlation so that women will have all the facts.” Given that LBW/Prematurity is the leading cause of neonatal mortality, and of morbidity including CP, cerebral palsy, mental retardation, autism, epilepsy, blindness, deafness, lung impairment and serious infections, it is an egregious omission that induced abortion is rarely found in the well known list of risk factors for preterm birth. That the association is stronger with decreasing gestational age is especially pernicious, as increasing prematurity brings increasing morbidity/mortality. (An associated write up of this article by LifeSiteNews can be found at http://www.lifesitenews.com/news/abortion-linked-to-significantly-increased-chance-of-preterm-birth-canadian/) Why not suggest to your residency director that your program do a review of the literature on “Induced abortion and subsequent preterm birth?” AAPLOG can suggest 137 articles for starters!