Study of environmental, social, and paternal factors in preterm delivery using sibs and half sibs. A population-based study in Denmark

Objective-The aim of this study was to evaluate the influence on preterm de livery of changes in putative genetic and environmental risk factors betwee n two consecutive births. Low social status is a suspected risk indicator o f preterm delivery, but the impact of social mobility has not been studied before. Participants-The study uses national cohorts in which women act as their ow n controls. Subjects were identified by means of registries: 10 455 women w ho gave birth to a preterm child and had a subsequent live birth between 19 80 and 1992 and 9849 women who gave birth to a child after 37 completed wee ks of gestation and had a subsequent live born child in the same time perio d formed the cohorts. Methods-The risk of having a premature infant in the subsequent pregnancy w as analysed in each cohort as a function of changes in male partner, reside ncy, occupation, and social status between the two pregnancies. Results-There was a strong tendency to repeat a preterm delivery (18% v 6% in the general population). Social decline was associated with a moderate i ncrease in the recurrence risk (OR: 1.22; 95% CI: 1.02, 1.47). In the refer ence cohort the risk of preterm delivery associated with changing from a ru ral to an urban municipality was 2.03 (95% CI: 1.14, 3.64). Conclusions-Social decline and moving to an urban municipality may be assoc iated with preterm delivery.