Morbidity risk among young adolescents undergoing elective abortion.

ABSTRACT

A cohort study comparing risks of morbidity at the time of elective abortion between 399 young adolescents aged 17 years or less matched to 399 women aged 20 to 29 years was completed. The study matched for duration of gestation, types of procedure, parity, race, month of procedure, and insurance status. Results indicated a relative risk of post-abortal endometritis for adolescents compared to older women of 2.5 (95% C.L. 1.48, 3.85). The reasons for this difference are unclear.

ABSTRACT

PIP To determine whether younger teenagers (age 17 years or less) face differing morbidity than other women, a cohort study comparing risks of morbidity at the time of elective abortion between 399 young adolescents aged 17 years or less matched with 399 women aged 20-29 years was undertaken. Only women undergoing suction curettage up to 14 weeks duration of gestation or urea amnioinfusion in combination with intraamniotic prostaglandin F2alpha or intravenous oxytocin at 16-22 weeks duration of gestation were included. Cohert subjects were women who had undergone their abortion care in Fertility Control Center at Johns Hopkins Hospital (Baltimore, Maryland) between January 1, 1976 December 31, 1978. The occurence of endometritis was the only complication found more frequently among the adolescents to a significant degree. Among the endometritis patients, 7 adolescents and 2 control women were hospitalized for intravenous antibiotic therapy. The study indicates that adolescents undergoing abortion procedures are at increased risk for postabortal endometritis once other factors such as gestational age, type of abortion procedure, parity, race, level of operation traning, and socioeconomic status have been controlled. Cervical laceration has been shown previously to be about twice as common among women aged 17 years or less compared with older women. The current study demostrated a similar trend but not to a statistically significant degree. Reasons for the increased rated of postabortal endometritis are unclear. The study demonstrated increased rates of preexisting cervical gonorrhea and urinary tract infection among the adolescents compared with the older women, but all of these women underwent treatment prior to the procedure and none experienced endometritis. Careful monitoring after the procedure for the occurence of infection is of obvious importance. Whether routine use of prophylactic antibiotics in this group would be of substantial benefit may deserve further study.