A new approach to assessing the effect of birth order on the outcome of pregnancy

Yudkin, Patricia; Baras, Mario

doi:10.1017/s0021932000014644

Cited by 12 publications

(7 citation statements)

References 24 publications

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“…Primiparous mothers exhibited a higher risk of stillbirth than multiparous mothers. This finding is consistent with the risk pattern observed in both prospective and retrospective studies (Bakketeig & Hofman, 1989;Leridon, 1976;Roman et al, 1978;Yudkin & Baras, 1983).…”

Section: Discussionsupporting

confidence: 91%

“…Genetically defective fetuses are also found more frequently among older mothers (Carr, 1971;James, 1970;Resseguie, 1974). This study showed that previous fetal wastage is associated with an increased risk of spontaneous miscarriage (Roman et al, 1978;Yudkin & Baras, 1983) and even one previous fetal loss increased the risk of stillbirth (cf. Swenson & Harper, 1979).…”

Section: Discussionmentioning

confidence: 87%

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The relationship between sociodemographic variables and pregnancy loss in a rural area of Bangladesh

et al. 1991

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 87%

The relationship between sociodemographic variables and pregnancy loss in a rural area of Bangladesh

et al. 1991

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“…28 It is also possible that long intervals are selective of women in poorer health, who take longer to conceive 29 or that women who have long intervals did not want to become pregnant again and do not take as good care of themselves during pregnancy. 12 In addition, long IPIs are more likely for older women; older maternal age is associated with its own independent adverse effects on pregnancy outcomes, 30 though we see an effect even when we control for maternal age.…”

Section: Comparison To Other Studiesmentioning

confidence: 99%

How long after a miscarriage should women wait before becoming pregnant again? Multivariate analysis of cohort data from Matlab, Bangladesh

2012

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ObjectiveTo determine the optimum interpregnancy interval (IPI) following a miscarriage.DesignMultivariate analysis of population-based, prospective data from a demographic surveillance system.SettingPregnancies in Matlab, Bangladesh, between 1977 and 2008.Participants9214 women with 10 453 pregnancies that ended in a miscarriage and were followed by another pregnancy outcome.Main outcome measuresOutcome of pregnancy following the miscarriage was singleton live birth, stillbirth, miscarriage or induced abortion. For pregnancies that ended in live birth: early neonatal, late neonatal and postneonatal mortality.ResultsCompared with IPIs of 6–12 months, pregnancies that were conceived ≤3 months after a miscarriage were more likely to result in a live birth and less likely to result in a miscarriage (adjusted relative risk ratio (RRR) 0.70, 95% CI 0.57 to 0.86) or induced abortion (0.50, 0.29 to 0.89). Induced abortions were significantly more likely following IPIs of 18–24 months (2.36, 1.48 to 3.76), 36–48 months (2.73, 1.50 to 4.94), and >48 months (3.32, 1.68 to 2.95), and miscarriages were more likely following IPIs of 12–17 months (1.25, 1.01 to 1.56) and >48 months (1.90, 1.40 to 2.58). No significant effects of IPI duration are seen on the risks of a stillbirth. However, IPIs≤3 months following a miscarriage are associated with significantly higher late neonatal mortality for the infant born at the end of the IPI (adjusted hazard ratio (HR) 1.74, 1.06 to 2.84), and IPIs of 12–18 months are associated with a significantly lower unadjusted risk of postneonatal mortality (0.54, 0.30 to 0.96).ConclusionsThe shorter the IPI following a miscarriage, the more likely the subsequent pregnancy is to result in a live birth. However, very short IPIs may not be advisable following miscarriages in poor countries like Bangladesh because they are associated with a higher risk of mortality for the infants born after them.

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“…Bakketeig and Hoffman 14 modelled the prevalence of preterm births stratified by parity cohorts based on the women's ultimate family size to demonstrate that preterm birth did not increase with parity, but abortions were not included. Yudkin and Baras 15 published a study investigating the sequential effect of preceding birth outcomes by stratifying their data by parity. Carr‐Hill and Hall 6 looked at permutations of sequences of abortions, preterm and term livebirths and showed that compared with women who had had no prior preterm births, the percentage of preterm births after a previous preterm birth was tripled and increased sixfold after two previous preterm births with or without a preceding abortion.…”

Section: Discussionmentioning

confidence: 99%

“…Some earlier attempts to model the effect of the sequence of prior pregnancy outcomes (i.e. combinations of births and abortions) 6,13–17 had limited data and were undertaken prior to the availability of sophisticated statistical software. None has investigated the complex sequence of all prior pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Modelling sequence of prior pregnancies on subsequent risk of very preterm birth

Watson

Rayner

King

et al. 2010

Paediatric and Perinatal Epidemiology

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The prevalence and intractability of preterm birth is known as is its association with reproductive history, but the relationship with sequence of pregnancies is not well studied. The data were from a population-based case-control study, conducted in Victoria, Australia. The study recruited women giving birth between April 2002 and April 2004 from 73 maternity hospitals. Detailed reproductive histories were collected by interview a few weeks after the birth. The cases were 603 women having a singleton birth between 20 and <32 weeks gestation (very preterm births including terminations of pregnancy). The controls were 796 randomly selected women from the population having a singleton birth of at least 37 completed weeks gestation. Unconditional logistic regression was used to assess the association of very preterm birth with sequence of pregnancies defined by their outcome (prior abortion - spontaneous or induced, and prior preterm or term birth) with adjustment for sociodemographic factors. The outcomes of each prior pregnancy, stratified by pregnancy order, and starting with the pregnancy immediately before the index or control pregnancy, were categorised as one of abortion, preterm birth or term birth. We showed that each of these prior pregnancy events was an independent risk of very preterm birth. This finding does not support the hypothesis of a neutralising effect of a term birth after an abortion on the subsequent risk for very preterm birth and is further evidence for the cumulative or increasing risk associated with increasing numbers of prior abortions or preterm births.

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A new approach to assessing the effect of birth order on the outcome of pregnancy

Cited by 12 publications

References 24 publications

The relationship between sociodemographic variables and pregnancy loss in a rural area of Bangladesh

The relationship between sociodemographic variables and pregnancy loss in a rural area of Bangladesh

How long after a miscarriage should women wait before becoming pregnant again? Multivariate analysis of cohort data from Matlab, Bangladesh

Modelling sequence of prior pregnancies on subsequent risk of very preterm birth

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