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January 22, 2026Archives of Gynecology and Obstetrics0 citationsOpen Access

Risk of preterm birth and peripartal complications after first trimester termination of pregnancy: a retrospective cohort study of 35,897 singleton births

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CGCaroline GabryschLSLivia SchirruWHWolfgang Henrich

Key Points

  • To investigate the relationship between first trimester termination of pregnancy and the incidence of preterm birth and peripartal complications.
  • Analyzed 35,897 singleton births from 2015 to 2022
  • Compared individuals with a history of first trimester termination of pregnancy to those without
  • Utilized Chi-squared analysis and forward-step multiple logistic regression for data exploration.
  • 11.51% of individuals had a prior history of first trimester termination of pregnancy
  • History of termination linked to 44% increased risk of preterm birth
  • Six or more terminations significantly associated with higher odds of spontaneous preterm birth (OR = 5.21)
  • Association identified between past termination and placental retention (OR = 1.25)

Abstract

Abstract Purpose The objective of this study was to explore whether a history of termination of pregnancy (TOP) in births after 2015 in a high income setting is still linked to preterm birth (PTB) and peripartal complications. Methods 35,897 singleton births from a perinatal center with approximately 5000 births per year between 2015 and 2022 were analyzed. Patients with a history of first trimester TOP (TOP < 15 weeks) were compared to those who had never had a TOP. A two-step statistical approach using Chi-squared analysis and forward-step multiple logistic regression was used to explore the relationship. Results 4132 individuals (11.51%) had a history of first trimester TOP. Our findings suggest an association between past TOP and a higher risk for PTB (OR = 1.44, 95% CI 1.25–1.67, p < 0.001). This increases with the number of TOP, six or more TOP were associated with the highest odds ratio for spontaneous PTB (OR = 5.21, 95% CI 1.88–14.46, p = 0.002). The risk for PTB did not differ between methods. Furthermore, our data suggest an association between past TOP and placental retention (OR = 1.25, 95% CI 1.03–1.52, p = 0.022). Conclusion These findings underscore the importance of still recognizing prior TOP as a risk factor in obstetric care. The results may inform targeted counseling and the development of preventative strategies to mitigate maternal and fetal morbidity.

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Cite This Study

Gabrysch et al. (2026) studied this question.

synapsesocial.com/papers/6971bd4c642b1836717e208chttps://doi.org/10.1007/s00404-025-08242-w
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