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

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Abstract

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.

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Acknowledgments

The original ART surveillance system data used for this study were collected by the Society for Assisted Reproductive Technology (SART). This system is jointly supported by SART, the American Society for Reproductive Medicine (ASRM), and the CDC. The authors thank SART and ASRM for their contributions to this work. The authors also gratefully acknowledge Maria Gallo, PhD, Jeffrey Wiener, MS, and William Callaghan, MD, MPH, for their helpful input and expertise.

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Authors and Affiliations

  1. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop K-34, Atlanta, GA, 30341, USA

    Naomi K. Tepper, Sherry L. Farr, John E. Anderson & Denise J. Jamieson

  2. Bureau of Health Information, Statistics, Research and Evaluation, Massachusetts Department of Public Health, 250 Washington St., 6th floor, Boston, MA, 02108, USA

    Bruce B. Cohen

  3. University of Massachusetts Lowell, Department of Nursing, College of Health and Environment, 3 Solomont Way, Suite 2, Lowell, MA, 01854, USA

    Angela Nannini

  4. Center for Health Policy and Research, University of Massachusetts Medical School, 333 South Street, Shrewsbury, MA, 01545, USA

    Zi Zhang

  5. University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45229, USA

    Maurizio Macaluso

Authors
  1. Naomi K. Tepper
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  2. Sherry L. Farr
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  3. Bruce B. Cohen
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  4. Angela Nannini
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  5. Zi Zhang
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  6. John E. Anderson
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  7. Denise J. Jamieson
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  8. Maurizio Macaluso
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Corresponding author

Correspondence to Naomi K. Tepper.

Additional information

Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

At the time of the study, Dr. Nannini was at the Massachusetts Department of Public Health, Boston, MA.

At the time of the study, Dr. Zhang was at the Massachusetts Department of Public Health, Boston, MA.

At the time of the study, Dr. Macaluso was at the Centers for Disease Control and Prevention, Atlanta, GA.

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Tepper, N.K., Farr, S.L., Cohen, B.B. et al. Singleton Preterm Birth: Risk Factors and Association with Assisted Reproductive Technology. Matern Child Health J 16, 807–813 (2012). https://doi.org/10.1007/s10995-011-0787-8

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  • DOI: https://doi.org/10.1007/s10995-011-0787-8

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