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Intergenerational effects of preterm birth and reduced intrauterine growth: A population-based study of Swedish mother-offspring pairs
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.
2006 (English)In: British Journal of Obstetrics and Gynaecology, ISSN 0306-5456, E-ISSN 1365-215X, Vol. 113, no 4, 430-440 p.Article in journal (Refereed) Published
Abstract [en]

Objective To estimate the intergenerational effects of preterm birth and reduced intrauterine growth.

Design Population-based cohort study.

Settings Mother–first-born offspring pairs recorded in the Swedish Medical Birth Registry.

Population Children born before 2001 to 38 720 women born in 1973–75.

Methods The relationships between the mother's and the child's birth characteristics were estimated using logistic regression analysis. Adjustments were made for smoking habits, body mass index (BMI), and current and childhood socio-economic conditions. Analyses were performed on all mother–offspring pairs and on the pairs for which information on neither of the included background variables was missing (n= 24 520).

Main outcome measures Preterm birth (<37 weeks of gestation) and small for gestational age (SGA) (<−2 SD of the Swedish standard).

Results Mothers who themselves had been born preterm were not significantly more likely to deliver their own children preterm, compared with those who had been born at term (adjusted OR 1.24, 95% CI 0.95–1.62). Also, preterm birth in the mothers did not influence the occurrence of SGA in the children. However, the odds ratio for giving birth to SGA and preterm children, respectively, was higher among SGA mothers (OR 2.68, 95% CI 2.11–3.41 and OR 1.30, 95% CI 1.05–1.61). Mothers whose intrauterine growth was moderately reduced but who did not meet the criterion of being born SGA were also at higher risk of giving birth to both preterm and SGA children, respectively.

Conclusions The present study showed evidence of intergenerational effects of reduced intrauterine growth even when socio-economic factors as well as BMI and smoking were adjusted for. There was, however, no consistent intergenerational effect of preterm birth.

Place, publisher, year, edition, pages
2006. Vol. 113, no 4, 430-440 p.
Keyword [en]
preterm infant, registries, reproduction, small-for-gestational-age infant, women
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-14626DOI: 10.1111/j.1471-0528.2006.00872.xOAI: oai:DiVA.org:liu-14626DiVA: diva2:24056
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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British Journal of Obstetrics and Gynaecology
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