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Trends and risk of recurrent preterm birth in pregnancy cohorts in rural Bangladesh, 1990-2019
Int Ctr Diarrhoeal Dis Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
Int Ctr Diarrhoeal Dis Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
Int Ctr Diarrhoeal Dis Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..ORCID iD: 0000-0002-7877-858X
Int Ctr Diarrhoeal Dis Res, Maternal & Child Hlth Div, Dhaka, Bangladesh..
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2023 (English)In: BMJ Global Health, E-ISSN 2059-7908, Vol. 8, no 11, article id e012521Article in journal (Refereed) Published
Abstract [en]

Introduction: A history of preterm birth reportedly increases the risk of subsequent preterm birth. This association has primarily been studied in high-income countries and not in low-income settings in transition with rapidly descending preterm birth figures. We evaluated the population-based trends of preterm births and recurrent preterm births and the risk of preterm birth recurrence in the second pregnancy based on prospectively studied pregnancy cohorts over three decades in Matlab, Bangladesh.

Methods: A population-based cohort included 72 160 live births from 1990 to 2019. We calculated preterm birth and recurrent preterm birth trends. We assessed the odds of preterm birth recurrence based on a subsample of 14 567 women with live-born singletons in their first and second pregnancies. We used logistic regression and presented the associations by OR with a 95% CI.

Results: The proportion of preterm births decreased from 25% in 1990 to 13% in 2019. The recurrent preterm births had a similar, falling pattern from 7.4% to 3.1% across the same period, contributing 27% of the total number of preterm births in the population. The odds of second pregnancy preterm birth were doubled (OR 2.18; 95% CI 1.96 to 2.43) in women with preterm birth compared with the women with term birth in their first pregnancies, remaining similar over the study period. The lower the gestational age at the first birth, the higher the odds of preterm birth in the subsequent pregnancy (test for trend p<0.001).

Conclusion: In this rural Bangladeshi setting, recurrent preterm births contributed a sizeable proportion of the total number of preterm births at the population level. The increased risk of recurrence remained similar across three decades when the total proportion of preterm births was reduced from 25% to 13%.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2023. Vol. 8, no 11, article id e012521
Keywords [en]
Public Health, Cohort study, Epidemiology, Child health
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-520514DOI: 10.1136/bmjgh-2023-012521ISI: 001107322900002PubMedID: 37984897OAI: oai:DiVA.org:uu-520514DiVA, id: diva2:1827629
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Sida - Swedish International Development Cooperation AgencyAvailable from: 2024-01-15 Created: 2024-01-15 Last updated: 2024-01-15Bibliographically approved

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Moshfiqur Rahman, Syed

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