{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:44:12Z","timestamp":1791276252882,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,11,6]],"date-time":"2012-11-06T00:00:00Z","timestamp":1352160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare the effect of medical versus surgical termination of pregnancy (<jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>), performed in primigravid women, on subsequent delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based register study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Finland 2000\u20132009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All primigravid women (<jats:italic>n<\/jats:italic>\u00a0=\u00a08294) who underwent <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> during first trimester of pregnancy by medical (<jats:italic>n<\/jats:italic>\u00a0=\u00a03441) or surgical (<jats:italic>n<\/jats:italic>\u00a0=\u00a04853) method, and whose subsequent pregnancy resulted in singleton delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The women were identified in the Finnish Register of Induced Abortions, and the data were linked to the Medical Birth and the Hospital Discharge Registries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Risk of preterm birth, low birthweight, small\u2010for\u2010gestational\u2010age (<jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content>) infant and placental complications (placenta praevia, placental abruption, retained placenta, placenta accreta).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No statistically significant differences in the incidences of preterm birth (4.0% in the medical group versus 4.9% in the surgical group), low birthweight (3.4% versus 4.0%), <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> infants (2.6% versus 2.9%) or placental complications (2.6% versus 2.8%) emerged between the two groups. After adjusting for various background factors, medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> was not associated with significantly altered risks of preterm birth (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 0.87, 95% confidence interval [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.68\u20131.13), low birthweight (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.90, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.68\u20131.19), <jats:styled-content style=\"fixed-case\">SGA<\/jats:styled-content> infant (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.87, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.64\u20131.20) or placental complications (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.98, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.72\u20131.34) versus surgical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>. In a sub\u2010analysis excluding women who underwent surgical evacuation following the index <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>, medical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content> was associated with a reduced risk of preterm birth (<jats:italic>P\u00a0<\/jats:italic>&lt;\u00a00.01), but the difference became insignificant after adjusting for gestational age at the time of <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>, inter\u2010pregnancy interval, maternal age, cohabitation status, socio\u2010economic status, residence and smoking during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A history of one medical versus surgical <jats:styled-content style=\"fixed-case\">TOP<\/jats:styled-content>, performed in primigravid women, is associated with similar obstetric risks in the subsequent delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12034","type":"journal-article","created":{"date-parts":[[2012,11,6]],"date-time":"2012-11-06T11:16:47Z","timestamp":1352200607000},"page":"331-337","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Medical versus surgical termination of pregnancy in primigravid women\u2014is the next delivery differently at risk? 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