Hon. Representative Henry Waxman (9 July 2010)
8423 W. Third St. (Suite 600)
Los Angeles, California 90048
Copies to: William McGurn (Wall Street Journal),
Senator Dr. John Barrasso,
Senator Dr. Tom Coburn
Open Letter Hon. Rep. Henry Waxman (D, California),
Being very concerned about the health of
Hispanic-American women, you would never
want even one Hispanic-American woman to
be subjected to an elective (i.e. unnecessary)
surgery that raises her future risk of a preterm
and handicapped newborn baby. Earlier in 2010
we asked you to provide a citation of a
SYSTEMATIC REVIEW that did NOT report
that prior IAs ( Induced Abortions ) boost a
woman's risk of a future premature delivery.
Unless you can provide such a citation before
mid August, an 'IN PRESS' letter will reveal that
you, Hon. Rep. Henry Waxman, have not provided
the required citation. A copy of that coming letter
is in the P.S. of this letter. If you can provide the
required citation, email may be the quickest way to
do so (+ hard copy confirmation via snail mail;
Brent Rooney <[email protected]>
Brent Rooney <[email protected]>
Dr. Jane Orient <[email protected]>,
You will be doing young California women a wonderful
service by warning them about elective surgeries that
represent the plausible future risk of preterm and handicapped
newborn. You well know that premature babies have
elevated odds of 'MACE' ( Mental retardation, Autism,
Cerebral palsy, & Epilepsy) disorders, blindness, deafness,
serious infections, respiratory distress, etc.
Thank you, for considering this health threat to young
Brent Rooney (MSc)
Research Director, Reduce Preterm Risk Coalition
3456 Dunbar St. (Suite 146) Vancouver, Canada V6S 2C2
P.S. 'In Press' letter to be published in September 2010
Abortion and Pre-term Delivery
In his 2008 article,  Brent Rooney asserts that the
high preterm birth rate suffered by African-American
women is, in large part, caused by the high abortion
rate of that race. Do other races or groups in the U.S.
or other countries also suffer the same effect?
Toorak, Victoria, Australia
Author Reply: The first-ever systematic reviews and
meta-analyses (SRMAs) of the abortion-preterm-birth
(APB) risk appeared in 2009, with both finding significantly
higher premature delivery (PTD) risk for women with prior
IAs (induced abortions).[2,3]
Prakesh Shah of the University of Toronto,  using data
from 37 prior APB studies, reported that more than one prior IA nearly
doubles PTD odds (OR 1.93; 95% CI, 1.28-2.71)). There are no
SRMAs reporting that prior IAs do not raise PTD risk. Some of the
countries included in the Shah meta-analysis are Australia, Scotland,
France, Italy, Germany, Denmark, Israel, Taiwan, Greece,, U.S.,
Finland, Sweden and Russia.
Swingle et al.  reported that women with prior IAs have
64% higher odds of very preterm delivery (<32.0 weeks' gestation)
than women with no prior IAs.
Extremely preterm newborns (<28 weeks' gestation) have
an autism risk of 25%  and a cerebral palsy (CP) risk of 14.6%.
 Between 1989 and 1993, Poland's IA rate per 1,000 births plunged
by 98%. Between 1995 and 1997, Poland's rate of extremely
preterm newborns decreased by 21%. Between 1989 and 2006,
Poland's mortality rate for children under age 5 years with CP
plummeted by 71%, according to data I received by email from
Poland's Central Statistical Office on June 12, 2008. This trend
suggests a dramatic drop in the incidence of severe brain injury,
a major cause of both autism and CP,  in Polish newborns.
The total lifetime cost of autism for a U.S. resident, including
medical and nonmedical expenses and lost income, is an
estimated $3.2 million, according to Harvard researcher Michael
Ganz.  The approximately 39,000 cases of autism presenting in
the U.S. each year represent a future drain of about $125 billion on
the U.S. economy. Prior IA is likely the cause of some of those cases
No ethnic group has been shown to be exempt from the APB risk.
Ross et al.  showed a 31% higher odds of PTB in women with
previous IAs compared with women with no IAs. In this study,
performed at the University of California at Los Angeles, 84% of
the women were of 'Hispanic' ethnicity. We challenged the
congressional representative from this district, Henry Waxman, to find
any systematic review performed in this century that did not find
an APB risk. So far he has provided no citations.
Calhoun et al.  estimate that 31.5% of U.S. very preterm
deliveries in 2002 were attributable to prior IAs, and that 1,096 cases
of CP in newborns under 1,500 grams were attributable to prior IAs.
Harvard University professors Dr. Robert Fletcher and Dr.
Suzanne Fletcher identified the category of medical study that
provides the highest confidence that a purported risk factor is
an actual risk factor as a Systematic Review. 
Brent Rooney, M.Sc.
Vancouver, B.C., Canada
1. Rooney B. Calhoun BC, Roche L. Does induced abortion
account for racial disparity in preterm births, and violate the
Nuremberg Code? J Am Phys Surg 2008;13:102-104.
2. Shah PS, Zao J. Induced termination of pregnancy and low
birthweight and preterm birth: a systematic review and meta-
analysis. BJOG 2009;116:1425-1442. [URL: http://www.bjog.org/details/journalArticle/345727/Induced_termination_of_pregnancy_and_low_birthweight_and_preterm_birth_a_systema.html ]
3. Swingle HM, Colaizy TT, Zimmerman MB, Moriss FH.
Abortion and the risk of subsequent preterm birth: a systematic
review and meta-analysis. J Reprod Med 2009;54:95-108.
4 Limperopoulos C. Autism spectrum disorders in survivors
of extreme prematurity. Clin Perinatol 2009;36:791-805.
5. Himpens E, Van Den Broeck C, Oostra A, Claders P,
Vanhaesebrouck P. Prevalence, type, and distribution and severity
of cerebral palsy in relation to gestational age: a meta-
analytic review. Dev Med Child Neurol 2008;50:334-340.
6. Ganz ML. The lifetime distribution of the incremental societal
costs of autism. Arch Pediatr Adolesc Med 2007;161:343-349.
7. Ross MG, Hobel CJ, Bragonier JR, et al. A simplified risk-scoring
system for prematurity. Am J Perinatol 1986;4:339-344.
8 Calhoun BC, Shadigian E, Rooney B. Cost consequences of
induced abortion as an attributable risk for preterm birth and
informed consent. J Reprod Med 2007;52:929-939.
9 [Book:] Fletcher RH, Fletcher SW. Clinical Epidemiology
The Essentials [Fourth Edition]. Lippincott Williams &
Wilkens, Philadelphia, Pennsylvania 2005
[End of Open Letter to Hon. Rep. Henry Waxman (9 July 2010)]
The following letter was 'snail mailed' to Rep. Hon. Henry Waxman to see if
he can identify (before 1 Feb. 2010) any 21st century SYSTEMATIC review of
all prior abortion-premature-birth studies to clearly show that prior induced
abortions do NOT raise future risk of premature birth.
“Induced abortion has been associated with very preterm delivery (<33 weeks) in
the French regional EPIPAGE study (OR 1.5, 95% CI 1.1-2.0) and this was con-
firmed by the International EUROPOP study across ten European countries.
The strength of association increased with decreasing gestational age and was con-
sistent across countries with varying rates of induced abortions. The increased risk
included idiopathic preterm labour, preterm premature rupture of membranes and
antepartum haemorrhage, but not maternal hypertension indicated delivery. In a
high-risk population of American women a previous second trimester delivery or
termination before 20 weeks was associated with pre-viable premature rupture of
membranes or labour (14-25 weeks).” [27, 28, 29 are references #s in Murphy's
article, NOT reference numbers in the Appendix you are reading]
In 2009 two SYSTEMATIC REVIEWS & combined data (i.e. 'meta-analysis')
studies confirmed the APB (Abortion-Preterm-Birth) risk.[8,9]. The October 2009
'Shah' study was published in the prestigious British Journal of Obstetrics &
In the U.S. “suction” abortion is the most frequently performed induced
abortion surgery. Perhaps, “suction” abortions pose no future 'preemie' risk for
Hispanic women. In 1986 UCLA Professor Michael Ross at al. reported on 22
potential 'preemie' risks (e.g.s. cigarette abuse, anemia, prior urinary tract infection).
[Ross, 4] Hispanic women dominated this study, comprising 84% of the subjects
from the Los Angeles, California area. Ross reported that women with prior
induced abortions significantly raised their preterm delivery odds by a relative
Fewer Induced Abortions Means Fewer Damaged HISPANIC Newborns
2 Rooney B, Calhoun BC, Roche L. Does induced abortion account for racial disparity
in preterm births, and violate the Nuremberg Code? J American Physicians Surgeons
2008;13(4):102-104 [ URL: http://www.jpands.org/vol13no4/rooney.pdf ]
3 Murphy DJ. Epidemiology and environmental factors in preterm labour. Best Practice &
Research Clinical Obstretrics and Gynaecology. 2007;21(5):773-789
4 Ross MG, Hobel CJ, Bragonier JR, Bear MB, Bemis RL. A Simplified Risk-Scoring
System For Prematurity. American J Perinatology 1986;3(4):339-344 URL:
5 Behrman RE, Butler AS, Alexander GR. [Book] Preterm Birth: Causes, Consequences,
and Prevention. National Academies Press 2007
6 Hamilton BE, Minino AM, Martin JA, Kochanek KD, Strobino DM. Annual Summary
of Vital Statistics: 2005. Pediatrics 2007;119(2):345-359
7 Rooney B, Calhoun BC. Induced abortion and risk of later premature births. J Amer
Phys Surg 2003;8(2):46-49 [ URL: http://www.jpands.org/vol8no2/rooney.pdf ]
[The only SYSTEMATIC published reviews of the Abortion-Preterm-Birth
risk of surgical abortion ever published (all between February 2009 and
November 2009), all reporting higher risk premature birth risk for women
with prior induced abortions:]
8 Shah P. et al. Induced termination of pregnancy and low birthweight and
preterm birth: a systematic review and meta-analysis BJOG 2009;116(11):
1425-1442 URL: http://www3.interscience.wiley.com/journal/122591273/abstract
10 van Oppenraaij RHF, Jauniaux E, Christiansen OB, et al. Predicting adverse
obstetric outcome after early pregnancy events and complications: a review.
Human Reproduction Update Advance Access 7 March 2009;1(1):1-13
- - 5 October 2009