Groundbreaking CLI Framework Reveals How Pregnancy Outcome Patterns May Affect Women’s Health

First-of-its-kind study establishes methodology to explore the connection between abortion and pregnancy loss

Washington D.C.—A new peer-reviewed study from the Charlotte Lozier Institute (CLI) introduces pregnancy outcome sequencing as a research framework by analyzing the number and order of all the pregnancy outcomes a woman experiences—live birth, abortion, or natural loss. The framework provides a new avenue for investigating how the entirety of a woman’s reproductive history affects her physical and mental health both during and after her reproductive years.

Published in JMIR Formative Research, the study used large-scale, anonymized Medicaid data, looking at over 14,000 pregnancies from over 5,000 women in a 17-year period, from 1999-2015. Historically, research on the effects of different pregnancy outcomes focus on a single metric or isolated event, like a woman’s first pregnancy or the risk of multiple abortions. By contrast, in this new study, researchers developed a set of unique algorithms, described as “counting methods” in the paper, to capture the number and order of all pregnancies in a woman’s reproductive history. This could help public health researchers determine how these patterns are associated with later health outcomes.

Potential future areas of study include:

• Diseases (heart disease or cancer)
• Health care system needs (emergency room visits or hospitalization)
• Behavioral events (suicidal thoughts or attempts)
• Patterns of prescription drug use

Early findings suggest a “dose-response relationship”—meaning that as women have more abortions, their risk of subsequent natural pregnancy loss may rise—between abortions and natural pregnancy loss, but that births have no association with natural loss no matter when or where they occur in a woman’s reproductive history. However, the researchers emphasize that limitations in the exploratory first application of the pregnancy outcome sequence require that the first results be considered preliminary and not conclusive.

The researchers are currently making modifications to the pregnancy outcome sequencing methodology based upon issues identified in the pilot study and a second application and analysis involving mental health events is underway.

Dr. James Studnicki, vice president and director of data analytics at CLI who developed the pregnancy outcome sequencing construct and led the research team, said:

“Experts in reproductive science may someday have a new tool that will influence the way we approach reproductive science. By examining all pregnancy outcomes in a reproductive history, pregnancy outcome sequencing may unlock associations that are not detectable by the other methods. Our research team is pleased JMIR Formative Research, a journal known for its focus on the development of innovative medical technologies and health related research methodologies, recognized that the unique approach represented by the pregnancy outcome sequencing should be published.”

CLI scholars worked in collaboration with Dr. Francois K. Domagni and Daniel Tsang from California State University, Northridge.

To read the full study, click here.

Charlotte Lozier Institute was launched in 2011 as the education and research arm of Susan B. Anthony Pro-Life America. CLI is a hub for research and public policy analysis on some of the most pressing issues facing the United States and nations around the world. The Institute is named for a feminist physician known for her commitment to the sanctity of human life and equal career and educational opportunities for women.

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