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American Journal of Epidemiology 2005 161(8):725-733; doi:10.1093/aje/kwi096
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

The Probability of Giving Birth among Women Who Were Born Preterm or with Impaired Fetal Growth: A Swedish Population-based Registry Study

K. Ekholm1, J. Carstensen2, O. Finnström3 and G. Sydsjö1

1 Division of Obstetrics and Gynecology, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden
2 Department of Health and Society, Linköping University, Linköping, Sweden
3 Division of Pediatrics, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Linköping, Sweden

Correspondence to Katarina Ekholm, Division of Obstetrics and Gynecology, Department of Molecular and Clinical Medicine, University Hospital, SE-581 85 Linköping, Sweden (e-mail: katarina.ekholm{at}lio.se).

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.

infant, small for gestational age; infant, very low birth weight; premature birth; registries; reproduction; women


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G. K. Swamy, T. Ostbye, and R. Skjaerven
Association of Preterm Birth With Long-term Survival, Reproduction, and Next-Generation Preterm Birth
JAMA, March 26, 2008; 299(12): 1429 - 1436.
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