In Reply

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In Reply:
We thank Mitchell D. Creinin and James Trussell for their interest in our work.1 In the analyses presented in our article, the gestational age at termination of pregnancy and the method of termination (medical compared with surgical) were used to adjust for the confounders and to ensure the comparability of the different termination-to-subsequent conception interval groups. Thus, these variables were included in the models, but the results were not presented according to them. After Drs. Creinin and Trussell raised a concern about the categorization of gestational age at termination of pregnancy, we re-analyzed our data by using a new division of gestational age at termination: 7 weeks or less, 8–12 weeks, 13–20 weeks, and 21–24 weeks. The first two groups represent the first-trimester terminations, and the latter two groups represent the second-trimester terminations. The new categorization of gestational age did not change our results. Women who conceived less than 6 months after termination had a slightly increased risk of preterm birth compared with women who conceived at 18 to less than 24 months after termination (adjusted odds ratio [OR] 1.34, 95% confidence interval [CI] 1.02–1.77, P=.036). Furthermore, we analyzed the data by using gestational age as a continuous and logarithmic variable in the model, and the result also persisted after these adjustments (adjusted OR 1.33, 95% CI 1.01–1.75 and adjusted OR 1.34, 95% CI 1.02–1.77, respectively). Thus, we conclude that an interval of less than 6 months between termination and subsequent pregnancy resulting in delivery is still associated with a slightly but significantly increased risk of preterm delivery. These data also highlight the importance of rapid initiation of effective contraception after a pregnancy termination.
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