Repeat abortions linked to premature birth

A large study published in Human Reproduction (1) looked at the effect of induced abortions on a subsequent first birth and found that women who have had three or more abortions have a higher risk of adverse birth outcomes, such as delivering premature and low birth weight babies.

Among 300,858 Finnish mothers, 31,083 (10.3%) had had one induced abortion between 1996-2008, 4,417 (1.5%) had two, and 942 (0.3%) had three or more induced abortions before a first birth (excluding twins and triplets). Those who had had three or more induced abortions had a statistically significant increased risk of having a baby with very low birth weight, low birth weight or of a preterm birth (before 37 weeks), or very preterm birth (before 28 weeks), compared to women who had had no abortions. There was a slightly increased risk of a very preterm birth for women who had had two induced abortions.

Most of the induced abortions (88%) were surgically performed and nearly all (91%) were performed before 12 weeks gestation. The researchers adjusted their findings to take account of various factors that could affect birth outcomes, such as social background, marital status, age, smoking, previous ectopic pregnancies and miscarriages. Multiple births (twins and triplets) were excluded.

Dr Reija Klemetti, an associate professor and senior researcher in public health at the National Institute for Health and Welfare in Helsinki, Finland, who led the research, said, "Our results suggest that induced abortions before the first birth, particularly three or more abortions, are associated with a marginally increased risk during the first birth. However, the increased risk is very small, particularly after only one or even two abortions, and women should not be alarmed by our findings."

The risk of having a baby born very pre-term appeared to increase slightly with each induced abortion, but only the risk from two abortions or more was statistically significant.

"To put these risks into perspective, for every 1000 women, three who have had no abortion will have a baby born under 28 weeks," said Klemetti. "This rises to four women among those who have had one abortion, six women who have had two abortions, and 11 women who have had three or more."

Among women who had had three or more abortions, there was increased risk of a third (35%) of having a baby born preterm (before 37 weeks), a two-fold (225%) increased risk of very low birth weight, and a two-fifths (43%) increased risk of low birth weight. The study also showed a small increased risk of a baby's death around the time of birth. However, the numbers for this finding were very low (1498 births or five per 1000 babies) and so should be treated with caution. In addition, the authors say they might not have been able to fully adjust for all the factors that could affect this result and perinatal deaths are sensitive to social factors such as poverty.

"Our study is the first large study to look at a broad set of perinatal outcomes and to control, at least partly, for the most important confounding factors such as smoking and socioeconomic position," said Klemetti. "However, it is important to say that even though we adjusted for these factors, and also ectopic pregnancies and miscarriages, there might be some confounding for social class that we could not control for. Most probably, this may be related to women's (or some of these women's) way of life, life habits, and sexual and reproductive health.

"Furthermore, this is an observational study and, however large and well-controlled, it only shows there is a link between abortion and some adverse birth outcomes – it cannot prove that abortions are the cause.

"Finland has one of the lowest rates of induced abortion in Europe (2), but even so, a large number are carried out every year. In addition, Finland has good quality abortion and maternity care, and in other contexts, particularly in poorer countries, the situation may be different. For these reasons, even a very small increase in the risk of poor birth outcomes could have significant health implications, as preterm births and low birth weight can have serious, adverse effects on the health and well-being of both babies and mothers.

"We suggest that the potential for increased risks for subsequent births should be included in sex education, especially as there are other, good reasons to avoid induced abortions. Health professionals should also be informed about the potential risks of repeat abortions."

Cholesterol Foods

Oats And Barley 

 When it comes to heart health, we can't stop singing the praises of oatmeal. But other grains, like barley, are also healthy picks. Both are packed with fiber -- which helps keep you full for longer so you reach for the chips less.

 But fiber does more than just keep you slim. Soluble fiber, the kind that the body can digest, seems to reduce the amount of cholesterol the body absorbs from the intestines, lowering total cholesterol and LDL or "bad" cholesterol in the process.

Fish 

You might think that fatty fish could be detrimental to your ticker, but the right seafood can lower cholesterol for a couple of reasons. First, eating more fish might mean that you're replacing meat in your diet, and meat contains more LDL-boosting saturated fats.

Second, fish like salmon, sardines and albacore tuna are high in omega-3 fatty acids, which have been shown to lower triglycerides.

Nuts 

Toss them in salads, sprinkle them on oatmeal or snack on them by the perfectly-portioned handful. Just about any variety of nut can lower total cholesterol, LDL and triglyceride levels, according to a 2010 analysis of data from 25 studies on nut consumption.

Olive Oil 

 Swapping the saturated fats found in butter for the unsaturated ones in oils is a good idea for both your waistline and your heart. Doing so can help reduce total cholesterol, but using olive oil in particular may also increase HDL, or "good" cholesterol.

Apples 

A medium-sized apple contains about 4 grams of LDL-lowering soluble fiber, or about 17 percent of your recommended daily intake. An apple a day can keep the heart doctor away!

Strawberries 

Strawberries are rich in pectin, a type of soluble fiber that can lower LDL. One study found that supplementing a heart-healthy diet with strawberries had similar results to adding oats to a heart-healthy diet -- and tasted better, too!.

Citrus Fruits 

You'll also find pectin in oranges, grapefruits and other citrus fruits. And adding more fiber to your diet can lower blood pressure and reduce inflammation, both of which help your heart.

 Beans And Lentils

Kidney, navy, garbanzos -- your favorite beans and lentils are all great sources of soluble fiber, which helps keep you full and can reduce cholesterol.

A 2008 study from Arizona State University found that people who ate a half-cup of beans a day (at the time, the recommended amount according to the U.S. Dietary Guidelines for Americans) over a 24-week period lowered their cholesterol by 8 percent.

If you eat around 2,000 to 2,500 calories a day, aim for a cup and a half to two cups of beans a week.

Soy

Like with fish, if you're eating soy, chances are you're eating less meat, which is higher in saturated fat and cholesterol. Soy is unique in the fact that it's a great source of protein, and yet it's free of any animal products, so it's also cholesterol free. However, it's not the cholesterol-busting superpower it was once touted to be. A 2010 study found that eating soy can result in a moderate 8 to 10 percent decrease in total cholesterol.

Red Wine You probably already know that a little alcohol -- in moderation of course -- is good for you. Part of the reason why? A 2000 study established that occasion clinking of glasses can raise HDL, or "good" cholesterol. Red wine may be particularly beneficial, since it's rich in antioxidants, which may lower LDL levels.