4.3.3 Risky behaviors and medical abortion
Women with planned pregnancies are reluctantly choosing abortion because of concerns that smoking and alcohol consumption may have a negative impact on the outcome of the pregnancy. Compared with never-smokers, active smokers in their reproductive years had a corresponding increase in the risk of spontaneous abortion, stillbirth and ectopic pregnancy by 16%, 44% and 43%, respectively[27]. A systematic review concluded that smoking interventions significantly increased birth weight[28]. Previous MR studies have found a positive correlation between smoking initiation and increased risk of pregnancy loss, but did not support any association between moderate alcohol and pregnancy loss[29, 30]. The present study found that smoking behavior motivated women to choose medical abortion.
Alcohol is known to have a significant negative impact on human health. Alcohol exposure is associated with an increased risk of congenital problems, including Fetal Alcohol Spectrum Disorder (FASD) and its most severe form, Fetal Alcohol Syndrome (FAS), which are long-lasting and lifelong with no treatment or cure available[31]. Many pregnant women choose abortion due to accidental exposure to alcohol before and during pregnancy, but our MR analyses did not provide valid evidence for this causal link.