SUBOPTIMAL PREGNANCY OUTCOME AMONG WOMEN WITH PRIOR ABORTIONS AND PREMATURE BIRTHS

Data from 25,958 consecutive UCLA [University of California-Los Angeles, USA] deliveries were analyzed to determine the effect of prior abortions and premature births on current pregnancy outcome. Perinatal death rate, combining stillbirths and neonatal deaths, increased more than 3-fold among women with at least 1 prior premature birth and at least 1 prior abortion and approached 18% of current deliveries when there were 3 or more prior premature births. Abnormal live births, defined as infants with birth weight < 2501 g gestational age < 37 wk, or congenital anomalies, significantly increased as the number of prior abortions and premature births increased, each in a range of 0 through 3 or more. For example, among women with at least 3 prior premature births, there were > 50% abnormal live births. The risk was mostly that of low birth weight and low gestational age, although there was a slight increase in congenital anomalies. The risk was reduced considerably when there were previous term births and was influenced variably by race, clinic classification, maternal illness and prior pregnancy complications. This empirical data on pregnancy outcome should be useful in reproductive counseling among women with pregnancy losses and premature births.