Marital status, cohabitation, and the risk of preterm birth in Europe: where births outside marriage are common and uncommon

Zeitlin, Jennifer; Saurel‐Cubizolles, Marie‐Josèphe; Ancel, Pierre‐Yves

doi:10.1046/j.1365-3016.2002.00396.x

Cited by 72 publications

(64 citation statements)

References 24 publications

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“…The effect pregnancy problems have been widely described in the literature. 2,14 The negative effect of previous pregnancies outcomes on early neonatal mortality more frequently studied are fetal losses or previous preterm births 19,21 and in the present study we found the effect of mothers having had previous low birth weight baby. Possibly, this set of variables expresses the presence of placental problems or adverse maternal conditions which affect the development of pregnancy and contribute to the occurrence of early neonatal death.…”

Section: Discussionsupporting

confidence: 55%

“…These results agree with other studies that point out paternal absence during pregnancy as a risk factor for neonatal death. 11,21,22 Recent union (less than 1 year) may express diffi culties of pregnant women in dealing with a new affective relationship together with pregnancy. The presence of domestic violence is in the pathway of early neonatal mortality (Table 5) is similar to the results found by other studies relating domestic violence and preterm, low birth weight and with neonatal mortality.…”

Section: Discussionmentioning

confidence: 99%

“…2,5,14 Others studies ha identifi ed also the presence of psychosocial factors in this pathway. These factors may generate stressful conditions (absence of partner, 11,21,22 presence of domestic violence, 13 smoking habit 19 and drug use 11 ) resulting in adverse infl uence in the development of the pregnancy. The present study aimed at identifying risk factors associated with early neonatal mortality in the south region of the city of São Paulo.…”

Section: Introductionmentioning

confidence: 99%

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Fatores de risco para mortalidade neonatal precoce

et al. 2007

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OBJECTIVE:To assess risk factors for early neonatal mortality. METHODS:A population-based case-control study was carried out with 146 early neonatal deaths and a sample of 313 controls obtained among survivals of the neonate period in the south region of the city of São Paulo, in the period of 8/1/2000 to 1/31/2001. Information was obtained through home interviews and hospital charts. Hierarchical assessment was performed in fi ve groups with the following characteristics 1) socioeconomic conditions of mothers and families, 2) maternal psychosocial conditions, 3) obstetrical history and biological characteristics of mothers, 4) delivery conditions, 5) conditions of newborns. RESULTS:Risk factors for early neonate mortality were: Group 1: poor education of household head (OR=1.6; 95% CI: 1.1;2.6), household located in a slum area (OR=2.0; 95% CI: 1.2;3.5) with up to one room (OR=2.2; 95% CI: 1.1;4.2); Group 2: mothers in recent union (OR=2.0; 95% CI: 1.0;4.2), unmarried mothers (OR=1.8; 95% CI: 1.1;3.0), and presence of domestic violence (OR=2.7; 95% CI: 1;6.5); Group 3: presence of complications in pregnancy (OR=8.2; 95% CI: 5.0;13.5), previous low birth weight (OR=2.4; 95% CI: 1.2;4.5), absence of pre-natal care (OR=16.1; 95% CI: 4.7;55.4), and inadequate pre-natal care (block 3) (OR=2.1; 95% CI: 2.0;3.5); Group 4: presence of clinical problems during delivery (OR=2.9; 95% CI: 1.4;5.1), mothers who went to hospital in ambulances (OR=3.8; 95% CI: 1.4;10.7); Group 5: low birth weight (OR=17.3; 95% CI: 8.4;35.6) and preterm live births (OR=8.8; 95% CI: 4.3;17.8). CONCLUSIONS:Additionally to proximal factors (low birth weight, preterm gestations, labor complications and unfavorable clinical conditions in gestation), the variables expressing social exclusion and presence of psychosocial factors were also identifi ed. This context may affect the development of gestation and hinder the access of women to health services. Adequate prenatal care could minimize the effect of these variables.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fatores de risco para mortalidade neonatal precoce

et al. 2007

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“…Furthermore, in Barcelona few women go ahead with their pregnancy in the absence of a "stable" partnership, contrary to northern European countries where the proportion of single women that have a baby is much higher (6.4 in The Netherlands or Sweden vs. 1.7 in Spain). 31 As in studies carried out in France 17 and Italy, 11 the association between educational level and abortion decision varies depending on age and partner cohabitation. Young women with higher educational level end their pregnancies more frequently in an IA, but this association disappears in older women.…”

Section: Discussionmentioning

confidence: 95%

Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision

et al. 2007

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Pregnancy planning allows women to better control their life trajectory and contributes to the future child's health and development. Many studies that have analyzed socioeconomic inequalities in unintended pregnancy only took into account those pregnancies ending in births. Few of them that analyzed unintended pregnancy, including both induced abortion and births, and its socioeconomic determinants, concluded that unintended pregnancy is more frequent in young, poor, or unmarried women. These inequalities have been poorly studied in Europe, especially in the southern European context. The aim of the present study is to describe socioeconomic inequalities in unintended pregnancy and in abortion decision in Barcelona, Spain. The major findings are that unintended pregnancies accounted for 41% of total pregnancy and of these, 60% ended in abortion. From all pregnancies, the proportion of induced abortion reached 25.6%. Compared to women with university studies, those with primary education uncompleted had more unintended pregnancies (OR=7.22). When facing an unintended pregnancy, women of lower socioeconomic position are more likely to choose induced abortion, although this is not the case among young or single women. This study reveals deep socioeconomic inequalities in unintended pregnancies and abortion decision in Barcelona, Spain, where the birth rate is very low and the abortion rate is rising. Women in low socioeconomic positions have many more unintended pregnancies than better educated women. Except for young or single women, the lower the socioeconomic position, the higher the proportion of women who choose an induced abortion when facing an unintended pregnancy.

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“…It was found that single women and mothers with short duration union had a higher risk of the outcome, which is consistent with other fetal death studies 7 and studies on pre-term births. 23 Mother's skin color was not significantly associated with antepartum fetal death. Similar result was obtained in another Brazilian study 2 for fetal deaths.…”

Section: Discussionmentioning

confidence: 82%

Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil

et al. 2007

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OBJECTIVE:To assess risk factors for antepartum fetal deaths. METHODS:A population-based case-control study was carried out in the city of São Paulo from August 2000 to January 2001. Subjects were selected from a birth cohort from a linked birth and death certificate database. Cases were 164 antepartum fetal deaths and controls were drawn from a random sample of 313 births surviving at least 28 days. Information was collected from birth and death certificates, hospital records and home interviews. A hierarchical conceptual framework guided the logistic regression analysis. RESULTS:Statistically significant factors associated with antepartum fetal death were: mother without or recent marital union; mother's education under four years; mothers with previous low birth weight infant; mothers with hypertension, diabetes, bleeding during pregnancy; no or inadequate prenatal care; congenital malformation and intrauterine growth restriction. The highest population attributable fractions were for inadequacy of prenatal care (40%), hypertension (27%), intrauterine growth restriction (30%) and absence of a long-standing union (26%). CONCLUSIONS:Proximal biological risk factors are most important in antepartum fetal deaths. However, distal factors -mother's low education and marital status -are also significant. Improving access to and quality of prenatal care could have a large impact on fetal mortality. KEYWORDS

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Marital status, cohabitation, and the risk of preterm birth in Europe: where births outside marriage are common and uncommon

Cited by 72 publications

References 24 publications

Fatores de risco para mortalidade neonatal precoce

Fatores de risco para mortalidade neonatal precoce

Socioeconomic Inequalities in Unintended Pregnancy and Abortion Decision

Risk-factors for antepartum fetal deaths in the city of São Paulo, Brazil

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