Abortion, changed paternity, and risk of preeclampsia in nulliparous women

Audrey F. Saftlas, Richard J. Levine, Mark A. Klebanoff, Karen L. Martz, Marian G. Ewell, Cynthia Morris, Baha M. Sibai

Research output: Contribution to journalArticle

97 Citations (Scopus)

Abstract

A prior birth confers a strong protective effect against preeclampsia, whereas a prior abortion confers a weaker protective effect. Parous women who change partners in a subsequent pregnancy appear to lose the protective effect of a prior birth. This study (Calcium for Preeclampsia Prevention Trial, 1992-1995) examines whether nulliparous women with a prior abortion who change partners also lose the protective effect of the prior pregnancy. A cohort analysis was conducted among participants in this large clinical trial of calcium supplementation to prevent preeclampsia. Subjects were nulliparous, had one prior pregnancy or less, delivered after 20 weeks' gestation, and were interviewed at 5-21 weeks about prior pregnancies and paternity. Women without a history of abortion served as the reference group in logistic regression analyses. Women with a history of abortion who conceived again with the same partner had nearly half the risk of preeclampsia (adjusted odds ratio = 0.54, 95 percent confidence interval: 0.31, 0.97). In contrast, women with an abortion history who conceived with a new partner had the same risk of preeclampsia as women without a history of abortion (adjusted odds ratio = 1.03, 95 percent confidence interval: 0.72, 1.47). Thus, the protective effect of a prior abortion operated only among women who conceived again with the same partner. An immune-based etiologic mechanism is proposed, whereby prolonged exposure to fetal antigens from a previous pregnancy protects against preeclampsia in a subsequent pregnancy with the same father.

Original languageEnglish (US)
Pages (from-to)1108-1114
Number of pages7
JournalAmerican Journal of Epidemiology
Volume157
Issue number12
DOIs
StatePublished - Jun 15 2003

Fingerprint

Paternity
Pre-Eclampsia
Induced Abortion
Pregnancy
Odds Ratio
Parturition
Confidence Intervals
Calcium
Fathers
Cohort Studies
Logistic Models
Regression Analysis
Clinical Trials
Antigens

Keywords

  • Abortion, induced
  • Abortion, spontaneous
  • Paternity
  • Pre-eclampsia
  • Pregnancy

ASJC Scopus subject areas

  • Epidemiology

Cite this

Saftlas, A. F., Levine, R. J., Klebanoff, M. A., Martz, K. L., Ewell, M. G., Morris, C., & Sibai, B. M. (2003). Abortion, changed paternity, and risk of preeclampsia in nulliparous women. American Journal of Epidemiology, 157(12), 1108-1114. https://doi.org/10.1093/aje/kwg101

Abortion, changed paternity, and risk of preeclampsia in nulliparous women. / Saftlas, Audrey F.; Levine, Richard J.; Klebanoff, Mark A.; Martz, Karen L.; Ewell, Marian G.; Morris, Cynthia; Sibai, Baha M.

In: American Journal of Epidemiology, Vol. 157, No. 12, 15.06.2003, p. 1108-1114.

Research output: Contribution to journalArticle

Saftlas, AF, Levine, RJ, Klebanoff, MA, Martz, KL, Ewell, MG, Morris, C & Sibai, BM 2003, 'Abortion, changed paternity, and risk of preeclampsia in nulliparous women', American Journal of Epidemiology, vol. 157, no. 12, pp. 1108-1114. https://doi.org/10.1093/aje/kwg101
Saftlas, Audrey F. ; Levine, Richard J. ; Klebanoff, Mark A. ; Martz, Karen L. ; Ewell, Marian G. ; Morris, Cynthia ; Sibai, Baha M. / Abortion, changed paternity, and risk of preeclampsia in nulliparous women. In: American Journal of Epidemiology. 2003 ; Vol. 157, No. 12. pp. 1108-1114.
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