Marriage still protects pregnancy

Abstract

Objective To assess the risk factors and outcome of pregnancy outside marriage in the 1990s, in conditions of a high percentage of extramarital pregnancies and high standard maternity care, used by the entire pregnant population. Design Hospital-based cohort study.Setting A university-teaching hospital in Finland.Population The 25,373 singleton pregnancies of known marital and cohabiting status.Methods Odds ratios (ORs) with 95% confidence intervals were calculated to estimate the effect of extramarital childbearing on pregnancy outcome. Multiple logistic regression analyses were conducted to control for confounding maternal risk factors. Main outcome measures Small-for-gestational age (SGA) infants, preterm birth (less than 37 completed weeks), low birthweight (LBW; under 2500 g). ResultsOf the study population, 67.5% were married and 32.5% were unmarried; 24.2% of all mothers were cohabiting. Unmarried status was strongly associated with social disadvantage and particular risk factors, specifically unemployment, smoking and previous pregnancy terminations, which in turn had an impact on obstetric outcome. There were significantly more SGA infants among unmarried mothers (P < 0.001), with an absolute difference of 45%; more preterm deliveries (P ¼ 0.001), with an absolute difference of 17.5%; and more LBW infants (P < 0.001), with an absolute difference of 26%. The differences in adverse pregnancy outcomes between study groups (i) all unmarried women, (ii) cohabiting women and (iii) single women, remained significant after multivariate analysis at adjusted ORs of 1.11, 1.11 and 1.07 for SGA, 1.17, 1.15 and 1.21 for LBW and 1.15, 1.15 and 1.29 for the preterm births, respectively. Conclusion Even in the 1990s when cohabitation was already common, pregnancy outside marriage was associated with an overall 20% increase of adverse outcomes, and free maternity care did not overcome the difference.

Medical and Sociodemographic Risk Factors for Preterm Birth in a French Caribbean Population of African Descent

“…We identified two categories of marital status, single mothers (living on their own) and single women living with their families, that were associated with a risk of preterm birth. The particular vulnerability of single women has already been repeatedly demonstrated [27,28].…”

The Impact of Nurse Case Management Home Visitation on Birth Outcomes in African-American Women

“…[12][13][14][15][16][17] Nurse case managers in the Black Babies SMILE program reported observations that many of their clients were "stressed," and that unmet psychosocial and behavioral needs often impacted clients' abilities to successfully address a range of health-related behaviors, including adherence to regular medical care (personal communications with S. Jackson and N. Williams). While results of this study suggest that the program has a positive impact on preterm delivery, future studies should aim to replicate these findings and to identify which components of the program are responsible for producing the observed effects.…”

Single motherhood and low birthweight in Spain

“…The association between maternal unmarried status and poor birth outcomes has also been reported by a large number of studies in different countries (Bennett 1992, Pattenden, Dolk, and Vrijheid 1999, Luo, Wilkins, and Kramer 2004, Raatikainen, Heiskanen, and Heinonen 2005, Meggiolaro 2009), including Spain (Rodríguez, Regidor, and Gutiérrez-Fisac 1995). The pathways through which marital status might influence pregnancy outcomes, including birthweight, are numerous and difficult to disentangle.…”