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A population-based study of the frequency and predictors of induced abortion among women with schizophrenia

  • Hilary K. Brown (a1), Cindy-Lee Dennis (a2), Paul Kurdyak (a3) and Simone N. Vigod (a4)
Abstract
Background

Induced abortion is an indicator of access to, and quality of reproductive healthcare, but rates are relatively unknown in women with schizophrenia.

Aims

We examined whether women with schizophrenia experience increased induced abortion compared with those without schizophrenia, and identified factors associated with induced abortion risk.

Method

In a population-based, repeated cross-sectional study (2011–2013), we compared women with and without schizophrenia in Ontario, Canada on rates of induced abortions per 1000 women and per 1000 live births. We then followed a longitudinal cohort of women with schizophrenia aged 15–44 years (n = 11 149) from 2011, using modified Poisson regression to identify risk factors for induced abortion.

Results

Women with schizophrenia had higher abortion rates than those without schizophrenia in all years (15.5–17.5 v. 12.8–13.6 per 1000 women; largest rate ratio, 1.33; 95% CI 1.16–1.54). They also had higher abortion ratios (592–736 v. 321–341 per 1000 live births; largest rate ratio, 2.25; 95% CI 1.96–2.59). Younger age (<25 years; adjusted relative risk (aRR), 1.84; 95% CI 1.39–2.44), multiparity (aRR 2.17, 95% CI 1.66–2.83), comorbid non-psychotic mental illness (aRR 2.15, 95% CI 1.34–3.46) and substance misuse disorders (aRR 1.85, 95% CI 1.47–2.34) were associated with increased abortion risk.

Conclusions

These results demonstrate vulnerability related to reproductive healthcare for women with schizophrenia. Evidence-based interventions to support optimal sexual health, particularly in young women, those with psychiatric and addiction comorbidity, and women who have already had a child, are warranted.

Declaration of interest

None.

Copyright
Corresponding author
Correspondence: Hilary K. Brown, Interdisciplinary Centre for Health & Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C 1A4, Canada. Email: hk.brown@utoronto.ca
Footnotes
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Previously presented as a poster at the Canadian National Perinatal Research Meeting in Banff, Alberta, Canada, on 14 February 2018.

Footnotes
References
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A population-based study of the frequency and predictors of induced abortion among women with schizophrenia

  • Hilary K. Brown (a1), Cindy-Lee Dennis (a2), Paul Kurdyak (a3) and Simone N. Vigod (a4)
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