Previous Adverse Outcome of Term Pregnancy and Risk of Preterm Birth in Subsequent Pregnancy

  • Rebecca J. BaerEmail author
  • Vincenzo Berghella
  • Louis J. Muglia
  • Mary E. Norton
  • Larry Rand
  • Kelli K. Ryckman
  • Laura L. Jelliffe-Pawlowski
  • Monica R. McLemore


Objective Evaluate risk of preterm birth (PTB, < 37 completed weeks’ gestation) among a population of women in their second pregnancy with previous full term birth but other adverse pregnancy outcome. Methods The sample included singleton live born infants between 2007 and 2012 in a birth cohort file maintained by the California Office of Statewide Health Planning and Development. The sample was restricted to women with two pregnancies resulting in live born infants and first birth between 39 and 42 weeks’ gestation. Logistic regression was used to calculate the risk of PTB in the second birth for women with previous adverse pregnancy outcome including: small for gestational age (SGA) infant, preeclampsia, placental abruption, or neonatal death (≤ 28 days). Risks were adjusted for maternal factors recorded for second birth. Results The sample included 133,622 women. Of the women with any previous adverse outcome, 4.7% had a PTB while just 3.0% of the women without a previous adverse outcome delivered early (relative risk adjusted for maternal factors known at delivery 1.4, 95% CI 1.3–1.5). History of an SGA infant, placental abruption, or neonatal death increased the adjusted risk of PTB in their second birth by 1.5–3.7-fold. History of preeclampsia did not elevate the risk of a preterm birth in the subsequent birth. Conclusions for Practice The findings indicate that women with previous SGA infant, placental abruption, or neonatal death, despite a term delivery, may be at increased risk of PTB in the subsequent birth. These women may be appropriate participates for future interventions aimed at reduction in PTB.


Preterm birth Poor adverse pregnancy outcome Placental abruption Small for gestational age Neonatal death 



Supported by the California Preterm Birth Initiative within the University of California, San Francisco, USA.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rebecca J. Baer
    • 1
    • 2
    Email author
  • Vincenzo Berghella
    • 3
  • Louis J. Muglia
    • 4
  • Mary E. Norton
    • 5
  • Larry Rand
    • 2
    • 5
  • Kelli K. Ryckman
    • 6
  • Laura L. Jelliffe-Pawlowski
    • 2
    • 7
  • Monica R. McLemore
    • 2
    • 8
  1. 1.Department of PediatricsUniversity of California, San DiegoLa JollaUSA
  2. 2.The California Preterm Birth InitiativeUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Department of Obstetrics and GynecologySidney Kimmel Medical Center of Thomas Jefferson UniversityPhiladelphiaUSA
  4. 4.Center for Prevention of Preterm Birth, Perinatal InstituteCincinnati Children’s Hospital Medical CenterCincinnatiUSA
  5. 5.Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of California, San FranciscoSan FranciscoUSA
  6. 6.Departments of Epidemiology and PediatricsUniversity of IowaIowa CityUSA
  7. 7.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA
  8. 8.Department of Family Health Care Nursing, School of NursingUniversity of California, San FranciscoSan FranciscoUSA

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