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Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study.
Acta Obstet Gynecol Scand 2016; 95(5):565-71AO

Abstract

INTRODUCTION

Despite high access to contraceptive services, 42% of the women who seek an abortion in Sweden have a history of previous abortion(s). The reasons for this high repeat abortion rate remain obscure. The objective of this study was to study the choice of contraceptive method after abortion and related odds of repeat abortions within 3-4 years.

MATERIAL AND METHODS

This is a retrospective cohort study based on a medical record review at three hospitals in Sweden. We included 987 women who had an abortion during 2009. We reviewed medical records from the date of the index abortion until the end of 2012 to establish the choice of contraception following the index abortion and the occurrence of repeat abortions. We calculated odds ratios (OR) with 95% CI.

RESULTS

While 46% of the women chose oral contraceptives, 34% chose long-acting reversible contraceptives (LARC). LARC was chosen more commonly by women with a previous pregnancy, childbirth and/or abortion. During the follow-up period, 24% of the study population requested one or more repeat abortion(s). Choosing LARC at the time of the index abortion was associated with fewer repeat abortions compared with choosing oral contraceptives (13% vs. 26%, OR 0.36; 95% CI 0.24-0.52). Subdermal implant was as effective as intrauterine device in preventing repeat abortions beyond 3 years.

CONCLUSIONS

Choosing LARC was associated with fewer repeat abortions over more than 3 years of follow up.

Authors+Show Affiliations

Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. Department of Obstetrics and Gynecology, Region Jönköping County, Jönköping, Sweden.Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.Department of Obstetrics and Gynecology, Vrinnevis Hospital, Norrköping, Sweden.Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.Department of Obstetrics and Gynecology and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26871269

Citation

Kilander, Helena, et al. "Likelihood of Repeat Abortion in a Swedish Cohort According to the Choice of Post-abortion Contraception: a Longitudinal Study." Acta Obstetricia Et Gynecologica Scandinavica, vol. 95, no. 5, 2016, pp. 565-71.
Kilander H, Alehagen S, Svedlund L, et al. Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study. Acta Obstet Gynecol Scand. 2016;95(5):565-71.
Kilander, H., Alehagen, S., Svedlund, L., Westlund, K., Thor, J., & Brynhildsen, J. (2016). Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study. Acta Obstetricia Et Gynecologica Scandinavica, 95(5), pp. 565-71. doi:10.1111/aogs.12874.
Kilander H, et al. Likelihood of Repeat Abortion in a Swedish Cohort According to the Choice of Post-abortion Contraception: a Longitudinal Study. Acta Obstet Gynecol Scand. 2016;95(5):565-71. PubMed PMID: 26871269.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Likelihood of repeat abortion in a Swedish cohort according to the choice of post-abortion contraception: a longitudinal study. AU - Kilander,Helena, AU - Alehagen,Siw, AU - Svedlund,Linnea, AU - Westlund,Karin, AU - Thor,Johan, AU - Brynhildsen,Jan, Y1 - 2016/03/14/ PY - 2015/11/15/received PY - 2016/01/25/accepted PY - 2016/2/13/entrez PY - 2016/2/13/pubmed PY - 2016/8/25/medline KW - Long-acting reversible contraception KW - post-abortion contraception KW - repeat abortion KW - subdermal implant KW - termination of pregnancy SP - 565 EP - 71 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 95 IS - 5 N2 - INTRODUCTION: Despite high access to contraceptive services, 42% of the women who seek an abortion in Sweden have a history of previous abortion(s). The reasons for this high repeat abortion rate remain obscure. The objective of this study was to study the choice of contraceptive method after abortion and related odds of repeat abortions within 3-4 years. MATERIAL AND METHODS: This is a retrospective cohort study based on a medical record review at three hospitals in Sweden. We included 987 women who had an abortion during 2009. We reviewed medical records from the date of the index abortion until the end of 2012 to establish the choice of contraception following the index abortion and the occurrence of repeat abortions. We calculated odds ratios (OR) with 95% CI. RESULTS: While 46% of the women chose oral contraceptives, 34% chose long-acting reversible contraceptives (LARC). LARC was chosen more commonly by women with a previous pregnancy, childbirth and/or abortion. During the follow-up period, 24% of the study population requested one or more repeat abortion(s). Choosing LARC at the time of the index abortion was associated with fewer repeat abortions compared with choosing oral contraceptives (13% vs. 26%, OR 0.36; 95% CI 0.24-0.52). Subdermal implant was as effective as intrauterine device in preventing repeat abortions beyond 3 years. CONCLUSIONS: Choosing LARC was associated with fewer repeat abortions over more than 3 years of follow up. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/26871269/Likelihood_of_repeat_abortion_in_a_Swedish_cohort_according_to_the_choice_of_post_abortion_contraception:_a_longitudinal_study_ L2 - https://doi.org/10.1111/aogs.12874 DB - PRIME DP - Unbound Medicine ER -