Maternal and Child Health Journal

, Volume 16, Issue 4, pp 807–813

Singleton Preterm Birth: Risk Factors and Association with Assisted Reproductive Technology

  • Naomi K. Tepper
  • Sherry L. Farr
  • Bruce B. Cohen
  • Angela Nannini
  • Zi Zhang
  • John E. Anderson
  • Denise J. Jamieson
  • Maurizio Macaluso


The objectives of this study were to determine risk factors for early (less than 34 weeks gestation) and late (34–36 weeks gestation) preterm singleton birth, by assisted reproductive technology (ART) status. We linked data from Massachusetts birth records and ART records representing singleton live births from 1997 through 2004. Using multinomial regression models, we assessed risk factors for early and late preterm birth by ART status. From 1997 to 2004 in Massachusetts, among non-ART births, risk factors for early and late preterm birth were similar and included women <15 and ≥35 years of age, those of non-white race or Hispanic ethnicity, those with ≤12 years of education, those with chronic diabetes, those with gestational diabetes, those with gestational hypertension, those who smoked during pregnancy, those who used fertility medications, and those who had not had a previous live birth. Among ART births, risk factors for early and late preterm birth differed and odds of early preterm birth were increased among women with ≤12 years of education while odds of late preterm birth were increased among women with gestational diabetes. Odds of both early and late preterm birth were increased among women of non-white race or Hispanic ethnicity and among women with gestational hypertension. Among non-ART births, increased risk for preterm birth was more strongly related to socioeconomic factors than among ART births. Medical conditions were associated with an increased risk for preterm birth regardless of women’s ART status. Efforts to prevent preterm births should focus on reducing modifiable risk factors.


Assisted reproductive technology Early preterm birth Late preterm birth Risk factors 


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Copyright information

© Springer Science+Business Media, LLC (outside the USA)  2011

Authors and Affiliations

  • Naomi K. Tepper
    • 1
  • Sherry L. Farr
    • 1
  • Bruce B. Cohen
    • 2
  • Angela Nannini
    • 3
  • Zi Zhang
    • 4
  • John E. Anderson
    • 1
  • Denise J. Jamieson
    • 1
  • Maurizio Macaluso
    • 5
  1. 1.Division of Reproductive Health, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaUSA
  2. 2.Bureau of Health Information, Statistics, Research and EvaluationMassachusetts Department of Public HealthBostonUSA
  3. 3.University of Massachusetts Lowell, Department of NursingCollege of Health and EnvironmentLowellUSA
  4. 4.Center for Health Policy and ResearchUniversity of Massachusetts Medical SchoolShrewsburyUSA
  5. 5.University of Cincinnati College of MedicineCincinnatiUSA

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