Neonatal Morbidity and Outcome of Live Born Premature Babies After Attempted Illegal Abortion with Misoprostol

Escumalha, Manuela; Cunha, Manuel; Machado, Maria-Céu; Gouveia, Catarina; Vale, Fernando
May 2005
Pediatric Nursing;May/Jun2005, Vol. 31 Issue 3, p228
Academic Journal
Misoprostol is a synthetic prostaglandin currently employed to induce labor. Association with illegal abortion has been reported; however, neonatal outcome and morbidity after a failed attempt of abortion has not been described. Objectives: To report the association between misoprostol self-medication and preterm labor and to assess perinatal risk factors, morbidity and early outcomes. Methods: We conducted a prospective study of all very low birth weight (VLBW) infants delivered in Hospital Fernando Fonseca, during a 5-year period. VLBW infants were assigned to misoprostol group (MG) when preterm delivery was attributed to misoprostol and matched with newborns with similar gestational age, birth- weight, and gender. Results: During the study period 311 VLBW infants were born. Nineteen belonged to misoprostol group (MG) and 58 were selected for controls. Mothers from MG were significantly younger (21.5 vs 27.5, p=0.001) and from African origin (74 vs 31%, p=0.006), had significantly less prenatal care (21 vs 67%, p=0.000), less antenatal steroids (5 vs 50%, p=0.001), and were delivered less often by C-section (11 vs 60%, p=0,000). MG infants had significantly higher rates of patent ductus arteriosus (58 vs 29%, p=0.031) and chronic lung disease (47 vs 14%, p= 0.026). Mortality rate at 3 months was similar in both groups, but the incidence of abnormal neurodevelopment at 1 year of age was significantly higher in the MG (50 vs 16%, p= 0.02). Comments: The worse outcome of MG infants seems to be determined by prenatal, natal, and postnatal factors and we believe that misoprostol is probably a significant adjuvant cofactor.


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