THE ASSOCIATION OF CHANGE IN MATERNAL MARITAL-STATUS BETWEEN BIRTHS AND ADVERSE PREGNANCY OUTCOMES IN THE 2ND BIRTH

The relationships between change in marital status between two consecu tive births and adverse pregnancy outcomes at the second birth were in vestigated using linked Washington State 1980-93 white singleton birth certificates. Women who were married at the first birth had lower low birthweight (LBW) and small-size-for-gestational-age (SGA) rates at t hat birth than single women, and women married at the second birth had lower LBW, SGA and preterm delivery rates at that birth, regardless o f marital status at the first birth. Adjusted relative risks (RR) of L BW and SGA were significantly increased for initially married women wh o were single at the second birth compared with those who remained mar ried (RR = 1.4 and 1.3, respectively). Risks of LBW and SGA were signi ficantly decreased among initially single women who married by the sec ond birth, compared with those remaining single (RR = 0.7 for LBW and 0.8 for SGA). We conclude that the largely unstudied subgroup of previ ously married women is at increased risk for adverse pregnancy outcome s. Public health policy and programmes directed at high-risk mothers a nd infants should be aware of the specific physical and emotional need s of this group of child-bearing women.