Association of induced abortion with hypertensive disorders of pregnancy risk among nulliparous women in China: a prospective cohort study

Abstract

The relationship between induced abortion(IA) and hypertensive disorders of pregnancy(HDP) is inconclusive. Few studies have been conducted in China. In order to clarify the association between previous IA and risk of HDP, including gestational hypertension(GH) and pre-eclampsia(PE), we performed a community-based prospective cohort study enrolling 5191 eligible nulliparous women in selected 2 districts and 11 towns of Liuyang from 2013 to 2015. Multivariable logistic regression was conducted to examine whether IA was associated with HDP, GH and PE. Of the gravidea, 1378(26.5%) had a previous IA and 258(5.0%) diagnosed with HDP, including 141(2.7%) GH and 117(2.3%) PE. The difference in the incidence of GH and PE between gravidae having one versus those with two or more IAs was minimal. After adjustment for maternal age, body mass index at first antenatal visit, education, virus infection and history of medical disorders, previous IA was significantly associated with HDP (OR = 0.67, 95%CI = 0.49 to 0.91) and PE (OR = 0.61, 95%CI = 0.38 to 0.97), but not with GH (OR = 0.73, 95%CI = 0.49 to 1.10). Additional adjustment for occupation, living area, anemia, gestational diabetes mellitus, psychological stress, conception climate and infant sex, multivariable analysis provided similar results. In conclusion, previous IA was associated with a lower risk of PE among nulliparous women.

Association between previous spontaneous abortion and preeclampsia: a case–control study

“…This finding is in accordance with that of Lao et al, who reported that prior abortion reduced the risk of preeclampsia by 15.0% among primiparous women in China (adjusted relative risk = 0.85) [14]. Similarly, Su et al reported that a history of induced abortion was associated with a lower risk of preeclampsia among nulliparous women in China [15]. Moreover, as per a report in Norway, although two or more induced abortions reduced the risk of preeclampsia by 64.0%, one induced abortion marginally/moderately reduced the risk of preeclampsia (95% CI = 0.69-1.02] [16].…”

“…Several studies have reported an association between prior abortion and preeclampsia [5][6][7][8][9][10][11][12][13][14][15][16]. However, the results of these studies are inconsistent; while some studies have reported an increased risk of preeclampsia in women with a history of abortions [5][6][7][8], others have reported no such effect [9][10][11][12] or a reduced risk of preeclampsia in women with a history of abortions [13][14][15][16]. Moreover, most these studies have been conducted in high-income countries [7,9,13,16].…”

Pregnancy complications among nulliparous and multiparous women with advanced maternal age: a community-based prospective cohort study in China

“…Subjects for this study were recruited from multiple maternal and child healthcare centers in Liuyang city, Hunan Province, China from June 2013 to December 2015 [ 18 ]. Liuyang is a county-level city located in the central-south region of China.…”

A Case Report On: Incomplete Abortion with Chronic Hypertension

“…Epidemiological studies have revealed that Hypertensive disorders of pregnancy is positively associated with the risk of future chronic disease, for example, heart failure, dysrhythmia, stroke, hypertension, diabetes mellitus(DM), end-stage renal failure etc. [9]. Substantial evidence indicates that women with a history of spontaneous abortion have a greater risk of non-communicable diseases, including hypertension, cardiovascular diseases, and type 2 diabetes [10].…”