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The probability of giving birth among women who were born preterm or with impaired fetal growth: A Swedish population-based registry study
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Pediatrics . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Obstetrics and gynecology . Linköping University, Faculty of Health Sciences.
2005 (English)In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 161, no 8, 725-733 p.Article in journal (Refereed) Published
Abstract [en]

The primary aim of this study was to investigate whether women born prematurely or with impaired fetal growth have a reduced probability of giving birth. Using Swedish population-based registries, the authors identified 148,281 women born in 1973–1975 for follow-up until 2001. Of these women, 4.1% were born preterm and 0.32% very preterm, 0.29% were born with a very low birth weight, and 5.4% were small for gestational age. Outcome measures were the hazard ratios for giving birth during the study period. Adjustments were made for socioeconomic factors. Very-low-birth-weight women displayed a reduced probability of giving birth (hazard ratio = 0.74, 95% confidence interval: 0.60, 0.91), most apparent among women aged 25 or more years. There were also tendencies of reduced hazard ratios of giving birth among women born preterm or very preterm in this age interval. Women born small for gestational age (below –2 standard deviations) seemed to be more likely to have given birth (hazard ratio = 1.09, 95% confidence interval: 1.04, 1.14), but when a more extreme group of small-for-gestational-age women (below –3 standard deviations) was defined, the association was less evident (hazard ratio = 1.04, 95% confidence interval: 0.94, 1.16). The results suggest that very-low-birth-weight women and, possibly, women born preterm or very preterm have a reduced probability of giving birth, while the results regarding small for gestational age are less clear.

Place, publisher, year, edition, pages
2005. Vol. 161, no 8, 725-733 p.
Keyword [en]
infant, small for gestational age; infant, very low birth weight; premature birth; registries; reproduction; women
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-14625DOI: 10.1093/aje/kwi096OAI: oai:DiVA.org:liu-14625DiVA: diva2:24055
Available from: 2007-08-24 Created: 2007-08-24 Last updated: 2017-12-13
In thesis
1. Birth-characteristics, hospitalisations, and childbearing: Epidemiological studies based on Swedish register data
Open this publication in new window or tab >>Birth-characteristics, hospitalisations, and childbearing: Epidemiological studies based on Swedish register data
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In the past decades there has been an improvement in the medical treatment of children born preterm or with reduced foetal growth. This has resulted in a much higher survival rate of these children, but also in a higher number of surviving children with chronic conditions. These changes have, in turn, increased interest in investigating the connection between birth-characteristics and outcomes in later life. The overall aim of the present thesis was to study the relations between birth-characteristics, subsequent hospitalisations, and childbearing by means of data available in Swedish population-based registries.

The study population in this thesis consisted of women (and men in Paper III) born in 1973-75 according to the Medical Birth Register and the Total Population Register. Information available in other registries, such as the Hospital Discharge Register, was obtained by individual record linkage.

In Paper I, 148,281 women, alive and living in Sweden at 13 years of age, were included. Of the women, 4.1% were born preterm and 5.4% were born small for gestational age, and approximately 30% of all women had given birth between 13 and 27 years of age. We found that reduced foetal growth and possibly preterm birth were related to the likelihood of giving birth during the study period. The intergenerational effects of preterm birth and reduced foetal growth were investigated in Paper II and the study population consisted of 38,720 mother-offspring pairs. An intergenerational effect of reduced foetal growth was found, and reduced foetal growth in the mother also increased the risk for preterm birth in the child.

Paper III was concerned with 304,275 men and women living in Sweden at 13 years of age. Of these men and women, 30% were hospitalised during adolescence and early adulthood (i.e. between 12 and 23 years of age). We found that men and women born small for gestational age or preterm were more likely to be hospitalised, and that those born small for gestational age seemed to be more at risk compared to those born preterm. Finally, in Paper IV, the relation between hospitalisations during adolescence and the likelihood of giving birth was studied in 142,998 women living in Sweden at 20 years of age. We found that a majority of the causes of hospitalisation during adolescence were positively connected to the likelihood of giving birth between 20 and 27 years of age. The relations presented in Papers I-IV were evident although socio-economic characteristics were adjusted for.

Place, publisher, year, edition, pages
Institutionen för molekylär och klinisk medicin, 2007
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1012
Keyword
Birth rate, Cohort studies, Epidemiology, Hospitalisation, Morbidity, Preterm infant, Reproduction, Small-for-gestational-age infant
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:liu:diva-9660 (URN)978-91-85831-50-0 (ISBN)
Public defence
2007-10-05, Berzeliussalen, Campus US, Ingång 65, Linköping, 09:00 (English)
Opponent
Supervisors
Available from: 2007-08-24 Created: 2007-08-24 Last updated: 2009-08-22

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Ekholm (Selling), KatarinaCarstensen, JohnFinnström, OrvarSydsjö, Gunilla

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American Journal of Epidemiology
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