50 years of comprehensive state-wide data on pregnancy termination in South Australia: a retrospective, population-based, cohort study

Termination of pregnancy is a common procedure, accessed globally, irrespective of logistical and legal barriers. We aimed to document changes in procedural characteristics and demographic factors over time in South Australia, as well as to examine how key sociodemographic variables affect gestation...

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Bibliographic Details
Published in:The Lancet. Public health 2024-11, Vol.9 (11), p.e925-e934
Main Authors: Slade, Laura J, Louise, Jennie, D’Onise, Katina, Dodd, Jodie M
Format: Article
Language:English
Subjects:
Abortion, Induced - legislation & jurisprudence
Abortion, Induced - statistics & numerical data
Abortion, Induced - trends
Adolescent
Adult
Cohort Studies
Female
Gestational Age
Humans
Pregnancy
Retrospective Studies
Sociodemographic Factors
Socioeconomic Factors
South Australia - epidemiology
Young Adult
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Summary:Termination of pregnancy is a common procedure, accessed globally, irrespective of logistical and legal barriers. We aimed to document changes in procedural characteristics and demographic factors over time in South Australia, as well as to examine how key sociodemographic variables affect gestational age at pregnancy termination. South Australian legislation has required mandatory collection of data related to pregnancy termination since 1970. We conducted a retrospective population-based cohort study of all pregnancy terminations in the state from 1970 to 2020. The primary outcome was gestational age at termination of pregnancy. Linear regression was used to examine socioeconomic characteristics that could confer disadvantage in access to pregnancy termination, with postcodes coded according to the 2016 Australian Statistical Geographical Classification–Remote Area system and the Index of Relative Socio-Economic Advantage and Disadvantage (IRSAD) from the Australian Bureau of Statistics 2018. Between Jan 1, 1970, and Dec 31, 2020, 225 440 pregnancy terminations were performed at a median of 8 weeks’ gestation (IQR 7–10). Most pregnant individuals (median age 24 years [IQR 20–31]) resided in urban areas (n=166 311 [77·9%]) and received surgical pregnancy termination (n=287 345 [78·4%]). Major complication rates remained low over time; however, major complications occurred more frequently at higher gestational ages. Gestational age at pregnancy termination decreased over time (from 9 weeks [IQR 8–11] in years 1970–75 to 7 weeks [6–9] in years 2016–20) and was strongly correlated with being a teenager (ie, aged
ISSN:2468-2667
2468-2667
DOI:10.1016/S2468-2667(24)00214-7