Objective: This study aimed to compare adrenocortical stress markers cortisol and dehydroepiandrosterone (DHEA-S) and preabortion psychological responses between women undergoing abortion for medical reasons and those undergoing voluntary induced abortion. Material and Methods: This prospective case-control study included 101 firsttrimester pregnant women (<10 weeks), of whom 50 underwent induced abortion for medical reasons (IAMR group) and 51 underwent voluntary induced abortion (VIA group). Pre-abortion serum cortisol and DHEA-S levels were measured. Anxiety and depression were evaluated using the Hospital Anxiety and Depression Scale (HADS). Age and parity differences between the groups were controlled for using analysis of covariance. Results: Women in the IAMR group were significantly younger than those in the VIA group (30.36±6.56 vs. 34.90±6.74 years, p=0.001), and parity was significantly higher in the VIA group (3.63±1.61 vs 2.48±2.47, p=0.001). After adjusting for age and parity, no significant differences were found between the groups in serum cortisol (p=0.828), DHEA-S levels (p=0.787), or HADS anxiety and depression scores (p=0.760). Hormone levels were not significantly correlated with HADS scores in either group. Conclusion: Pre-abortion adrenocortical stress markers and psychological parameters were similar between women undergoing medically indicated and voluntary abortions. These findings suggest that psychological and hormonal stress responses are multifactorial and not solely determined by the reason for pregnancy termination.
Ayçiçek et al. (Thu,) studied this question.