Women Who Undergo Medical, Surgical Abortions Have Similar Risk Of Tubal Pregnancy, Miscarriage In Future Pregnancies, NEJM Study Says

Main Category: Abortion
Also Included In: Pregnancy / Obstetrics;  Women's Health / Gynecology
Article Date: 20 Aug 2007 - 3:00 PDT

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Women who undergo medical abortions with the pills mifepristone and misoprostol have no greater risk of experiencing a tubal pregnancy or miscarriage in future pregnancies than women who undergo surgical abortions, according to a study published Thursday in the New England Journal of Medicine, the AP/Boston Globe reports (Stobbe, AP/Boston Globe, 8/15).

FDA in 2000 approved Mifeprex -- known generically as mifepristone -- to be taken in conjunction with the drug misoprostol to induce a medical abortion at up to 49 days' gestation (Kaiser Daily Women's Health Policy Report, 2/22). About 8% to 10% of all abortions in the U.S. are medical abortions, according to the AP/Globe.

For the study, Jun Zhang of the National Institute of Child Health and Human Development and colleagues used Denmark's national abortion registry to identify nearly 12,000 women in the country who obtained an abortion between 1999 and 2004. The researchers then collected data on the women's future pregnancies from national patient and birth registries.

The researchers found that tubal pregnancies, during which a fertilized egg implants outside the uterus, occurred in about 2.5% of women in both the medical abortion and surgical abortion groups (AP/Boston Globe, 8/15). The study also found about 12% of the women in both groups experienced a miscarriage. Women in the medical abortion group had a slightly lower risk of giving birth prematurely or of having a low-birthweight infant, but the difference was not statistically significant, Reuters reports.

Researchers' Comments, Reaction
The researchers looked at only the first pregnancy after the abortion and did not compare pregnancy outcomes among women who had a medical abortion and women who had never had an abortion. The researchers said that women who have never had an abortion often have different incomes, smoking rates and other health-related behaviors that would make it difficult to compare them to women who had abortions (Emery, Reuters, 8/15). "We chose not to compare women who had medical abortions directly with women who had no prior abortions, since these groups differ with respect to factors that affect pregnancy outcomes," the researchers wrote.

The conservative group Concerned Women for America said the study is "misleading," the Newark Star-Ledger reports. "It's most likely that women who have not had any abortions have safer (pregnancy) outcomes than women who have had either surgical or medical abortions," CWFA President Wendy Wright said (Stewart, Newark Star-Ledger, 8/16). The researchers wrote, "Many studies have concluded that surgical abortion in the first trimester does not increase the risk of ectopic pregnancy, spontaneous abortion, preterm birth or low birthweight in subsequent pregnancies," the researchers wrote (Reuters, 8/15).

Matthew Reeves -- a reproductive medicine expert at the University of Pittsburgh School of Medicine, who was not involved in the research -- said the study "kind of squashes" any concerns that embryonic material left in the uterus after medical abortions could interfere with future pregnancies (AP/Boston Globe, 8/15).

"Mifepristone medication abortion is a safe, effective option for early pregnancy termination," Vanessa Cullins, vice president for medical affairs for Planned Parenthood Federation of America, said, adding, "The data from this study shows health care providers and women that medication abortion compares very well with surgical abortion for safety and effectiveness for women who want to plan healthy pregnancies in the future" (HealthDay News/Forbes, 8/15).

The study abstract is available online.

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