PubMed · 9380383
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D Boda, L Pataki. 1997-09-21. [On Rh-D isoimmunization].. https://pubmed.ncbi.nlm.nih.gov/9380383/
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It has been hypothesized that an interrupted pregnancy might increase the risk of breast cancer, because proliferation of breast cells will take place without the protective effect of subsequent differentiation. In a cohort of 1.5 million women (28.5 million person-years) we identified 370,715 induced abortions in 280,965 women (2.7 million person-years) and 10,246 women with breast cancer. After adjustment for other risk factors, induced abortion was not associated with the risk of breast cancer (relative risk: 1.00; 95 percent confidence interval 0.94 to 1.06). However, the relative risk of breast cancer increased with increasing gestational age of the most recently induced abortion: < 7 weeks: 0.81; 7 to 8 weeks; 1.01; 9 to 10 weeks: 1 (reference); 11 to 12 weeks: 1.12; 13 to 14 weeks: 1.13; 15 to 18 weeks: 1.23; > 18 weeks: 1.89; P(trend) = 0.016. On a population basis, induced abortion was not associated with an increased risk of breast cancer. An increase was only seen for the special group of late second trimester abortions, but this finding was based on small numbers.
BACKGROUND: Fetal echocardiography is widely established in the United Kingdom for prenatal diagnosis of congenital heart disease. This may result in a substantial reduction in incidence at birth because of selected termination of pregnancy. The objective of this population-based study was to determine the incidence of pulmonary atresia with intact ventricular septum (PAIVS) at birth, the impact of fetal echocardiography on this incidence, and to compare the outcome of cases with and those without prenatal diagnosis. METHODS AND RESULTS: From 1991 to 1995, all infants born with PAIVS and all fetal diagnoses in the United Kingdom and Eire were studied. There were 183 live births (incidence 4.5/100,000 live births). The incidence was 4.1 cases per 100,000 live births in England and Wales, 4.7 in Scotland, 6.8 in Eire, and 9.6 in Northern Ireland (P=0.01). There were 86 fetal diagnoses made at a mean of 22.0 weeks of gestation leading to 53 terminations of pregnancy (61%), 4 intrauterine deaths (5%), and 29 live births (34%). The incidence at birth would be 5.6 per 100,000 births in England and Wales, 5.3 in Scotland, and unchanged in Eire and Northern Ireland, if there were no terminations of pregnancy and assuming no further spontaneous fetal deaths (P=0.28). An initial diagnosis of critical pulmonary stenosis was made in 6 cases, at a mean of 22.3 weeks of gestation with progression to PAIVS by 31.4 weeks. Probability of survival at 1 year was 65% and was the same for live-born infants whether or not a fetal diagnosis had been made. CONCLUSIONS: PAIVS is rare, occurring in 1 in 22,000 live births in the United Kingdom and Eire. Termination of pregnancy has resulted in an important reduction in the live-born incidence in mainland Britain.
This paper presents data from the California maternal serum alpha fetoprotein (MSAFP) program in order to explore the effect and interaction of various factors, especially ethnicity, abortion history and attitudes, religion, and religiosity on MSAFP test decision. The intent is to describe which women are more likely to reject MSAFP screening and also to understand the reasons for refusal and the meanings associated with it. We obtained data on sociodemographics and reproductive history from 595 obstetrical patient charts; we conducted semistructured interviews with an additional 158 pregnant women who were European-American, English-speaking Latina, or Spanish-speaking Latina. All of the women had been offered screening within the context of California's MSAFP Program. We found that women who had never terminated a pregnancy, Spanish-speaking Latinas, and women who scored high on a religiosity scale were significantly more likely to refuse testing. However, we found that all of those factors were strongly mediated by the effects of ethnicity and acculturation, producing different patterns of association in different groups of women.