Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort

Abstract Background Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were...

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Main Authors: Aline S. Rocha, Rita de Cássia Ribeiro-Silva, Rosemeire L. Fiaccone, Enny S. Paixao, Ila R. Falcão, Flavia Jôse O. Alves, Natanael J. Silva, Naiá Ortelan, Laura C. Rodrigues, Maria Yury Ichihara, Marcia F. de Almeida, Mauricio L. Barreto
Format: Article
Language:English
Published: BMC 2022-04-01
Series:BMC Medicine
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Online Access:https://doi.org/10.1186/s12916-022-02313-4
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author Aline S. Rocha
Rita de Cássia Ribeiro-Silva
Rosemeire L. Fiaccone
Enny S. Paixao
Ila R. Falcão
Flavia Jôse O. Alves
Natanael J. Silva
Naiá Ortelan
Laura C. Rodrigues
Maria Yury Ichihara
Marcia F. de Almeida
Mauricio L. Barreto
author_facet Aline S. Rocha
Rita de Cássia Ribeiro-Silva
Rosemeire L. Fiaccone
Enny S. Paixao
Ila R. Falcão
Flavia Jôse O. Alves
Natanael J. Silva
Naiá Ortelan
Laura C. Rodrigues
Maria Yury Ichihara
Marcia F. de Almeida
Mauricio L. Barreto
author_sort Aline S. Rocha
collection DOAJ
description Abstract Background Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB. Methods We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB. Results A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (P difference <0.05) between incident and recurrent PTB. The following were associated with an increased chance for PTB incidence, but not recurrent: household overcrowding (OR 1.09), maternal race/ethnicity [(Black/mixed—OR 1.04) and (indigenous—OR 1.34)], young maternal age (14 to 19 years—OR 1.16), and cesarean delivery (OR 1.09). The following were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85 vs 0.90), reduced number of prenatal visits [(no visit—OR 2.56 vs OR 2.16) and (1 to 3 visits—OR 2.44 vs OR 2.24)], short interbirth interval [(12 to 23 months—OR 1.04 vs OR 1.22) and (<12 months, OR 1.89, 95 vs OR 2.58)], and advanced maternal age (35–49 years—OR 1.42 vs OR 1.45). For most risk factors, the point estimates were higher for incident PTB than recurrent PTB. Conclusions The risk factors for PTB in the second pregnancy differed according to women’s first pregnancy PTB status. The findings give the basis for the development of specific prevention strategies for PTB in a subsequent pregnancy.
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spelling doaj.art-03dbb84ce08f4f458e0c9c01a332d2722022-12-21T19:00:56ZengBMCBMC Medicine1741-70152022-04-0120111010.1186/s12916-022-02313-4Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohortAline S. Rocha0Rita de Cássia Ribeiro-Silva1Rosemeire L. Fiaccone2Enny S. Paixao3Ila R. Falcão4Flavia Jôse O. Alves5Natanael J. Silva6Naiá Ortelan7Laura C. Rodrigues8Maria Yury Ichihara9Marcia F. de Almeida10Mauricio L. Barreto11School of Nutrition, Federal University of BahiaSchool of Nutrition, Federal University of BahiaCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationSchool of Nutrition, Federal University of BahiaCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationSchool of Public Health, University of São PauloCenter for Data and Knowledge Integration for Health (CIDACS), Oswaldo Cruz FoundationAbstract Background Preterm birth (PTB) is a syndrome resulting from a complex list of underlying causes and factors, and whether these risk factors differ in the context of prior PTB history is less understood. The aim of this study was to explore whether PTB risk factors in a second pregnancy were different in women with versus without previous PTB. Methods We conducted a population-based cohort study using data from the birth cohort of the Center for Data and Knowledge Integration for Health (CIDACS) for the period 2001 to 2015. We used longitudinal transition models with multivariate logistic regression to investigate whether risk factors varied between incident and recurrent PTB. Results A total of 3,528,050 live births from 1,764,025 multiparous women were analyzed. We identified different risk factors (P difference <0.05) between incident and recurrent PTB. The following were associated with an increased chance for PTB incidence, but not recurrent: household overcrowding (OR 1.09), maternal race/ethnicity [(Black/mixed—OR 1.04) and (indigenous—OR 1.34)], young maternal age (14 to 19 years—OR 1.16), and cesarean delivery (OR 1.09). The following were associated with both incident and recurrent PTB, respectively: single marital status (OR 0.85 vs 0.90), reduced number of prenatal visits [(no visit—OR 2.56 vs OR 2.16) and (1 to 3 visits—OR 2.44 vs OR 2.24)], short interbirth interval [(12 to 23 months—OR 1.04 vs OR 1.22) and (<12 months, OR 1.89, 95 vs OR 2.58)], and advanced maternal age (35–49 years—OR 1.42 vs OR 1.45). For most risk factors, the point estimates were higher for incident PTB than recurrent PTB. Conclusions The risk factors for PTB in the second pregnancy differed according to women’s first pregnancy PTB status. The findings give the basis for the development of specific prevention strategies for PTB in a subsequent pregnancy.https://doi.org/10.1186/s12916-022-02313-4Preterm birthIncident preterm birthRecurrent preterm birthRisk factorPoor populations
spellingShingle Aline S. Rocha
Rita de Cássia Ribeiro-Silva
Rosemeire L. Fiaccone
Enny S. Paixao
Ila R. Falcão
Flavia Jôse O. Alves
Natanael J. Silva
Naiá Ortelan
Laura C. Rodrigues
Maria Yury Ichihara
Marcia F. de Almeida
Mauricio L. Barreto
Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
BMC Medicine
Preterm birth
Incident preterm birth
Recurrent preterm birth
Risk factor
Poor populations
title Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
title_full Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
title_fullStr Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
title_full_unstemmed Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
title_short Differences in risk factors for incident and recurrent preterm birth: a population-based linkage of 3.5 million births from the CIDACS birth cohort
title_sort differences in risk factors for incident and recurrent preterm birth a population based linkage of 3 5 million births from the cidacs birth cohort
topic Preterm birth
Incident preterm birth
Recurrent preterm birth
Risk factor
Poor populations
url https://doi.org/10.1186/s12916-022-02313-4
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