Scientific Paper Abstracts Originally Presented at the National Abortion Federation's Annual Meeting; April 23, 2007; Boston, Massachusetts

In This Article

Risk Factors for Repeat Elective Abortion

Sarah Prager, MD, MAS; Jody Steinauer, MD, MAS; Diana Greene-Foster, PhD; Philip Darney, MD, MSc; Eleanor Drey, MD, EdM

Introduction and Purpose/Objective(s): Repeat abortion is common, accounting for 48% of induced abortions in the United States, and little is known about risk factors for repeat abortion. This study aims to identify correlates of repeat abortion in the United States.

Data-Collection Methods: A cross-sectional study was done on a consecutive sample of 398 women presenting for elective abortion in an urban hospital. All participants used audio computer-assisted self-interviewing (to improve accuracy of responses to sensitive topics) to answer questions regarding demographic, reproductive, and other factors. Analyses used bivariable and multivariable logistic regression.

Summary of Results: Women in their twenties were three times (OR 2.9, 95% CI 1.5-5.7) and women thirty or older six times (OR 6.7, 95% CI 2.8-16.0) more likely to present for repeat abortion than teenaged women. African-American race (adjusted OR 2.8, 95% CI 1.3-5.9) and abuse of alcohol/drugs (adjusted OR 2.6, 95% CI 1.3-5.3) also correlated with increased odds of repeat abortion. Second-trimester presentation (adjusted OR 0.6, 95% CI 0.3-0.97) had a decreased association with repeat abortion. Overall contraceptive use, as well as other variables, was not correlated with repeat abortion, however depot medroxyprogesterone acetate use approached a significant increased association with repeat abortion (3.2, [1.0-10.5]).

Conclusions: The association of older age and race with repeat abortion is consistent with previous studies. A new finding is the increased association between alcohol/drug use and repeat abortion. Future studies are needed to identify modifiable risk factors for repeat abortion, and to identify populations in which interventions, such as long-term contraception, may lower their risk.

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