The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: a retrospective cohort study

A retrospective cohort study

Nathalie Auger, Mark Daniel, Robert W. Platt, Zhong Cheng Luo, Yuquan Wu, Robert Choinière

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Interpregnancy interval (IPI), marital status, and neighborhood are independently associated with birth outcomes. The joint contribution of these exposures has not been evaluated. We tested for effect modification between IPI and marriage, controlling for neighborhood. Methods: We analyzed a cohort of 98,330 live births in Montréal, Canada from 1997-2001 to assess IPI and marital status in relation to small for gestational age (SGA) birth. Births were categorized as subsequent-born with short (<12 months), intermediate (12-35 months), or long (36+ months) IPI, or as firstborn. The data had a 2-level hierarchical structure, with births nested in 49 neighborhoods. We used multilevel logistic regression to obtain adjusted effect estimates. Results: Marital status modified the association between IPI and SGA birth. Being unmarried relative to married was associated with SGA birth for all IPI categories, particularly for subsequent births with short (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.31-1.95) and intermediate (OR 1.48, 95% CI 1.26-1.74) IPIs. Subsequent births had a lower likelihood of SGA birth than firstborns. Intermediate IPIs were more protective for married (OR 0.50, 95% CI 0.47-0.54) than unmarried mothers (OR 0.65, 95% CI 0.56-0.76). Conclusion: Being unmarried increases the likelihood of SGA birth as the IPI shortens, and the protective effect of intermediate IPIs is reduced in unmarried mothers. Marital status should be considered in recommending particular IPIs as an intervention to improve birth outcomes.

Original languageEnglish
Article number7
Pages (from-to)1-9
Number of pages9
JournalBMC Pregnancy and Childbirth
Volume8
DOIs
Publication statusPublished - 28 Feb 2008
Externally publishedYes

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Marital Status
Gestational Age
Cohort Studies
Retrospective Studies
Joints
Parturition
Odds Ratio
Confidence Intervals
Illegitimacy
Live Birth
Marriage
Canada
Logistic Models

Cite this

@article{320a64f3d39147daae2d5d6f24221ca7,
title = "The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: a retrospective cohort study: A retrospective cohort study",
abstract = "Background: Interpregnancy interval (IPI), marital status, and neighborhood are independently associated with birth outcomes. The joint contribution of these exposures has not been evaluated. We tested for effect modification between IPI and marriage, controlling for neighborhood. Methods: We analyzed a cohort of 98,330 live births in Montr{\'e}al, Canada from 1997-2001 to assess IPI and marital status in relation to small for gestational age (SGA) birth. Births were categorized as subsequent-born with short (<12 months), intermediate (12-35 months), or long (36+ months) IPI, or as firstborn. The data had a 2-level hierarchical structure, with births nested in 49 neighborhoods. We used multilevel logistic regression to obtain adjusted effect estimates. Results: Marital status modified the association between IPI and SGA birth. Being unmarried relative to married was associated with SGA birth for all IPI categories, particularly for subsequent births with short (odds ratio [OR] 1.60, 95{\%} confidence interval [CI] 1.31-1.95) and intermediate (OR 1.48, 95{\%} CI 1.26-1.74) IPIs. Subsequent births had a lower likelihood of SGA birth than firstborns. Intermediate IPIs were more protective for married (OR 0.50, 95{\%} CI 0.47-0.54) than unmarried mothers (OR 0.65, 95{\%} CI 0.56-0.76). Conclusion: Being unmarried increases the likelihood of SGA birth as the IPI shortens, and the protective effect of intermediate IPIs is reduced in unmarried mothers. Marital status should be considered in recommending particular IPIs as an intervention to improve birth outcomes.",
keywords = "Adult, birth intervals, Newborn, Health status, Logistic Regression, Retrospective Studies, risk assestment, maternal behavior",
author = "Nathalie Auger and Mark Daniel and Platt, {Robert W.} and Luo, {Zhong Cheng} and Yuquan Wu and Robert Choini{\`e}re",
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day = "28",
doi = "10.1186/1471-2393-8-7",
language = "English",
volume = "8",
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The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: a retrospective cohort study : A retrospective cohort study. / Auger, Nathalie; Daniel, Mark; Platt, Robert W.; Luo, Zhong Cheng; Wu, Yuquan; Choinière, Robert.

In: BMC Pregnancy and Childbirth, Vol. 8, 7, 28.02.2008, p. 1-9.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: a retrospective cohort study

T2 - A retrospective cohort study

AU - Auger, Nathalie

AU - Daniel, Mark

AU - Platt, Robert W.

AU - Luo, Zhong Cheng

AU - Wu, Yuquan

AU - Choinière, Robert

PY - 2008/2/28

Y1 - 2008/2/28

N2 - Background: Interpregnancy interval (IPI), marital status, and neighborhood are independently associated with birth outcomes. The joint contribution of these exposures has not been evaluated. We tested for effect modification between IPI and marriage, controlling for neighborhood. Methods: We analyzed a cohort of 98,330 live births in Montréal, Canada from 1997-2001 to assess IPI and marital status in relation to small for gestational age (SGA) birth. Births were categorized as subsequent-born with short (<12 months), intermediate (12-35 months), or long (36+ months) IPI, or as firstborn. The data had a 2-level hierarchical structure, with births nested in 49 neighborhoods. We used multilevel logistic regression to obtain adjusted effect estimates. Results: Marital status modified the association between IPI and SGA birth. Being unmarried relative to married was associated with SGA birth for all IPI categories, particularly for subsequent births with short (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.31-1.95) and intermediate (OR 1.48, 95% CI 1.26-1.74) IPIs. Subsequent births had a lower likelihood of SGA birth than firstborns. Intermediate IPIs were more protective for married (OR 0.50, 95% CI 0.47-0.54) than unmarried mothers (OR 0.65, 95% CI 0.56-0.76). Conclusion: Being unmarried increases the likelihood of SGA birth as the IPI shortens, and the protective effect of intermediate IPIs is reduced in unmarried mothers. Marital status should be considered in recommending particular IPIs as an intervention to improve birth outcomes.

AB - Background: Interpregnancy interval (IPI), marital status, and neighborhood are independently associated with birth outcomes. The joint contribution of these exposures has not been evaluated. We tested for effect modification between IPI and marriage, controlling for neighborhood. Methods: We analyzed a cohort of 98,330 live births in Montréal, Canada from 1997-2001 to assess IPI and marital status in relation to small for gestational age (SGA) birth. Births were categorized as subsequent-born with short (<12 months), intermediate (12-35 months), or long (36+ months) IPI, or as firstborn. The data had a 2-level hierarchical structure, with births nested in 49 neighborhoods. We used multilevel logistic regression to obtain adjusted effect estimates. Results: Marital status modified the association between IPI and SGA birth. Being unmarried relative to married was associated with SGA birth for all IPI categories, particularly for subsequent births with short (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.31-1.95) and intermediate (OR 1.48, 95% CI 1.26-1.74) IPIs. Subsequent births had a lower likelihood of SGA birth than firstborns. Intermediate IPIs were more protective for married (OR 0.50, 95% CI 0.47-0.54) than unmarried mothers (OR 0.65, 95% CI 0.56-0.76). Conclusion: Being unmarried increases the likelihood of SGA birth as the IPI shortens, and the protective effect of intermediate IPIs is reduced in unmarried mothers. Marital status should be considered in recommending particular IPIs as an intervention to improve birth outcomes.

KW - Adult

KW - birth intervals

KW - Newborn

KW - Health status

KW - Logistic Regression

KW - Retrospective Studies

KW - risk assestment

KW - maternal behavior

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U2 - 10.1186/1471-2393-8-7

DO - 10.1186/1471-2393-8-7

M3 - Article

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JF - BMC Pregnancy and Childbirth

SN - 1471-2393

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ER -