Young women who have a miscarriage or an abortion are three times
more likely to experience a drug or alcohol problem during their
lifetime, according to
new
research published in the December issue of the
British
Journal of Psychiatry.
Recent evidence has suggested that induced
abortion may be associated with later psychiatric disorders in
women. However, this study indicates that such disorders are more
likely to be associated with pregnancy loss per se, rather
than being caused by the experience of induced abortion.
To date, no studies have directly compared the
psychiatric outcomes of women who have had an abortion and those
who have experienced a miscarriage. In this study, researchers from
the University of Queensland examined 1,123 women from a cohort
born in Australia between 1981 and 1984. The women were assessed at
the age of 21 to find out how many pregnancies, abortions,
miscarriages and births they had experienced.
943 women had never been pregnant and 280
(22.9%) reported one or more pregnancies. Over a quarter of those
pregnant had complex lifetime histories, meaning they had
experienced two or three of the pregnancy outcomes (birth,
abortion, miscarriage).
The study showed that women who had
experienced pregnancy loss – whether abortion or miscarriage – were
at increased risk of illicit drug and alcohol use compared with
women who had never been pregnant or who gave birth.
Because abortion and miscarriage showed
similar associations with drug and alcohol use disorders, the
researchers claim their study challenges the existing evidence of a
causal link between abortion and illicit drug and alcohol use
disorders.
Writing in the British Journal of
Psychiatry, the authors said: “The findings suggest that poor
outcomes reported for women who had an induced abortion may be
associated with pregnancy loss rather than simply the experience of
abortion. Induced abortion and miscarriage are both stressful life
events that have been shown to lead to anxiety, sadness and grief
and, for some women, serious depression and substance use
disorders.”
The precise reasons behind the link are
unclear, but the authors put forward a number of possible
explanations. Pregnancy loss and substance misuse may have shared
risk factors. Unplanned pregnancy commonly occurs alongside
individual and social risk factors such as early sexual activity,
poor school performance, alcohol and illicit drug taking and
behaviour problems.
In addition, pregnancy loss may be directly
associated with an increased risk of later substance misuse,
particularly if alcohol and illicit drugs are used to decrease
emotional responses to the loss.
The researchers call for further studies to
better understand the relationship between pregnancy loss and
adverse psychiatric outcomes in young women.