Deaths associated with pregnancy outcome: a record linkage study of low income women

South Med J. 2002 Aug;95(8):834-41.


Background: A national study in Finland showed significantly higher death rates associated with abortion than with childbirth. Our objective was to examine this association using an American population over a longer period.

Methods: California Medicaid records for 173,279 women who had an induced abortion or a delivery in 1989 were linked to death certificates for 1989 to 1997.

Results: Compared with women who delivered, those who aborted had a significantly higher age-adjusted risk of death from all causes (1.62), from suicide (2.54), and from accidents (1.82), as well as a higher relative risk of death from natural causes (1.44), including the acquired immunodeficiency syndrome (AIDS) (2.18), circulatory diseases (2.87), and cerebrovascular disease (5.46). Results are stratified by age and time.

Conclusions: Higher death rates associated with abortion persist over time and across socioeconomic boundaries. This may be explained by self-destructive tendencies, depression, and other unhealthy behavior aggravated by the abortion experience.

MeSH terms

  • Abortion, Induced / mortality*
  • Adolescent
  • Adult
  • Age Factors
  • California / epidemiology
  • Delivery, Obstetric / mortality*
  • Female
  • Humans
  • Logistic Models
  • Medical Record Linkage*
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Socioeconomic Factors
  • Time Factors