Abstract Objectives: The objective of this study was to determine if an association exists between prior induced and prior spontaneous pregnancy termination (PIPT and PSPT) and preterm birth (PTB) of first live births in Virginia. Methods: Data was collected by linking maternal data from Virginia’s live birth and fetal death registries. All first live, singleton births occurring in Virginia from 2000-2007 were analyzed. Logistic regression models that controlled for various demographic, medical and obstetric history factors were used to determine associations among prior pregnancy termination types. Results: Compared with women who had no history of previous pregnancy terminations, women who had 1 (OR = 1.1, 95% CI 1.31, 1.53), 2 (OR = 1.2, 95% CI 1.12, 1.24) and 3 or more (OR = 1.4, 95% CI 1.07, 1.13) total prior pregnancy terminations had an increased odds of experiencing PTB. Increased odds of PTB were found for women who had 2 (OR = 1.1, 95% CI 1.05, 1.18) and 3 or more (OR = 1.3, 95% CI 1.39, 1.61) PIPTs. Women who reported 1, 2, 3 or more PSPT had PTB odds-ratios of 1.4 (95% CI 1.37, 1.50), 1.7 (95% CI 1.48, 1.98) and 3.0 (95% CI 2.09, 4.22) times, respectively. Conclusion: Two or more PIPT and one or more PSPT were found to be a significant risk factor for PTB of a first live birth in Virginia, and women having 3 or more PSPT had three times the odds of experiencing this outcome. Health practitioners should take this data into account to target research, education and action strategies to those high risk groups of women associated with obtaining induced terminations and to those women more susceptible to spontaneous termination of pregnancy.