A history of induced abortion in relation to substance use during subsequent pregnancies carried to term

Objective: Previous research has revealed a general association between induced abortion and substance use. The purpose of this study was to examine the correlation when substance use is measured specifically during a subsequent pregnancy. Study Design: A nationally representative sample of women was surveyed about substance use during pregnancy shortly after giving birth. Women with a previous induced abortion, whose second pregnancy was delivered, were compared separately with women with one previous birth and with women with no previous births. Results: Compared with women who gave birth, women who had had an induced abortion were significantly more likely to use marijuana (odds ratio, 10.29; 95% CI, 3.47-30.56), various illicit drugs (odds ratio, 5.60; 95% CI, 2.39-13.10), and alcohol (odds ratio, 2.22; 95% CI, 1.31-3.76) during their next pregnancy. The results with only first-time mothers were very similar. Conclusion: Psychosocial mechanisms that may explain the findings are discussed. Screening for abortion history may help to identify pregnant women who are at risk for substance use more effectively. (Am J Obstet Gynecol 2002;187:1673-8.)