Surreal illustration of maternal health balance.

Abortion History and Pregnancy Health: What Every Woman Should Know

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Kai Mendoza in Health & Wellness June 2025 • 4 min read.

"A new study reveals the surprising link between prior abortions and a reduced risk of hypertensive disorders during pregnancy."


Pregnancy hypertensive disorders (PHD), including gestational hypertension (GH) and pre-eclampsia (PE), present significant health challenges, particularly for first-time mothers. These conditions, characterized by elevated blood pressure and potential organ damage, have long been a focus of obstetric research. Traditionally, primiparous women—those experiencing their first pregnancy—face the highest risk, attributed to their initial exposure to fetal cells.

However, a growing body of evidence suggests a more complex interplay of factors, including the potential impact of prior abortions on subsequent pregnancy outcomes. While the protective effect of a previous successful pregnancy is well-documented, the role of prior abortions remains a subject of debate. Some studies indicate a protective effect, while others report no significant difference or even an increased risk under certain circumstances.

To shed light on this controversy, a recent study investigated the relationship between prior abortion history and the incidence of PHD in primiparous women. This research, conducted on a cohort of Chinese women, offers valuable insights into the potential long-term effects of abortion on pregnancy health and challenges existing paradigms.

Does Prior Abortion History Impact Pregnancy Hypertensive Disorders?

Surreal illustration of maternal health balance.

The study, a retrospective cohort analysis, examined data from 60,335 primiparous Chinese women managed at a single center between 1997 and 2015. Researchers meticulously analyzed the occurrence of PHD, GH, and PE in relation to the women's prior abortion history, while also considering other known risk factors. These included advanced maternal age (≥35 years), high body mass index (BMI >25 kg/m²), pre-existing medical conditions, preterm birth history (<34 weeks), hepatitis B virus (HBV) infection, and rubella non-immunity.

The findings revealed a surprising trend: women with a history of prior abortion had a lower incidence of PHD, GH, and PE compared to those without. Specifically, 39.3% of the gravidae had at least one prior abortion, and this group also presented distinct characteristics:

  • Higher incidence of advanced age, HBV infection, rubella non-immunity, and high BMI.
  • Lower incidence of PHD, GH, PE, and birth before 34 weeks gestation.
  • Minimal difference in GH and PE incidence between women with one versus multiple abortions.
  • The effect of abortion on PHD influenced by other risk factors.
Regression analysis further confirmed that prior abortion independently reduced the risk of PHD (adjusted relative risk [aRR] 0.761, 95% CI 0.684-0.846), GH (aRR 0.660, 95% CI 0.563-0.773), and PE (aRR 0.857, 95% CI 0.745-0.987).

Implications and Future Directions

This study offers valuable insights into the intricate relationship between prior abortion history and subsequent pregnancy health. The finding that prior abortion reduces the risk of hypertensive disorders challenges conventional understanding and warrants further investigation. While the study's strengths include a large cohort size and consideration of multiple risk factors, limitations such as data availability on abortion type and timing call for future prospective studies. Ultimately, this research underscores the need for personalized risk assessment and tailored management strategies to optimize pregnancy outcomes for all women.

About this Article -

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This article is based on research published under:

DOI-LINK: 10.1016/j.preghy.2018.10.001, Alternate LINK

Title: Prior Abortion History And Pregnancy Hypertensive Disorders In Primiparous Gravidae

Subject: Obstetrics and Gynecology

Journal: Pregnancy Hypertension

Publisher: Elsevier BV

Authors: Terence T. Lao, Annie S.Y. Hui, Lai-Wa Law, Daljit S. Sahota

Published: 2018-10-01

Everything You Need To Know

1

What is the surprising link discovered between prior abortions and pregnancy health?

The study revealed a connection between a history of prior abortions and a reduced risk of Pregnancy Hypertensive Disorders (PHD). Specifically, women with a history of prior abortions showed a lower incidence of PHD, including Gestational Hypertension (GH) and Pre-eclampsia (PE). This finding challenges traditional understanding, which typically identifies first-time mothers (primiparous women) as having the highest risk of these conditions.

2

How did the study investigate the impact of prior abortions on Pregnancy Hypertensive Disorders?

The study used a retrospective cohort analysis of 60,335 primiparous Chinese women. Researchers analyzed the occurrence of PHD, GH, and PE in relation to their prior abortion history. They also considered other known risk factors, such as advanced maternal age, high Body Mass Index (BMI), pre-existing medical conditions, preterm birth history, Hepatitis B Virus (HBV) infection, and rubella non-immunity. Through regression analysis, they found that prior abortion independently reduced the risk of PHD, GH, and PE.

3

What are Pregnancy Hypertensive Disorders (PHD) and why are they significant?

Pregnancy Hypertensive Disorders (PHD) encompass conditions like Gestational Hypertension (GH) and Pre-eclampsia (PE). These disorders are characterized by elevated blood pressure and potential organ damage during pregnancy. They are significant because they pose health challenges to both the mother and the developing fetus, especially affecting first-time mothers. Pre-eclampsia can lead to serious complications for the mother.

4

What were the key findings of the study concerning abortion history and PHD?

The study found that women with a history of prior abortion had a lower incidence of PHD, GH, and PE compared to those without. The group with prior abortions also presented a higher incidence of advanced age, HBV infection, rubella non-immunity, and high BMI, but despite these risk factors, they experienced fewer PHD, GH, and PE cases. The regression analysis confirmed this protective effect, with adjusted relative risk (aRR) values demonstrating reduced risk for all three conditions.

5

What are the implications of this research, and what further studies are needed?

This study suggests that prior abortion may have a protective effect against hypertensive disorders during pregnancy, challenging conventional understanding. The findings emphasize the need for personalized risk assessment and tailored management strategies to optimize pregnancy outcomes. Future prospective studies are needed, particularly those that collect data on the type and timing of abortions, to further explore this complex relationship and refine our understanding of the factors influencing pregnancy health.

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