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Adverse birth outcomes among nulliparous vs. multiparous women.

Publication ,  Journal Article
Miranda, ML; Edwards, SE; Myers, ER
Published in: Public Health Rep
2011

OBJECTIVES: Previous studies indicate that nulliparous women (i.e., women having no previous births) are at higher risk for adverse birth outcomes than multiparous women (i.e., women having had at least one previous birth). We examined whether part of the difference in adverse outcome rates is attributable to nulliparous women with poor pregnancy outcomes being less likely (through choice or fecundity differences) to have a subsequent live birth within the same time period as nulliparous women without adverse outcomes. METHODS: Using deterministic matching, we linked nulliparous women from the North Carolina Detailed Birth Record to subsequent births. We employed statistical and simulation-based analyses to estimate first birth outcome rate differences between nulliparous women who did have a subsequent live birth vs. those who did not. Our Markov simulations focused on preterm birth (PTB). RESULTS: Among nulliparous women who were not linked to a second birth, maternal age-adjusted rates of multiple adverse outcomes were all statistically higher compared with rates for linked women. These results also held in race/ethnicity-specific analyses. Simulations found that the relative risk of PTB associated with a history of PTB was underestimated if some women who would have been at risk for PTB did not experience a second birth. CONCLUSIONS: The observed differences in rates of adverse outcomes between nulliparous and multiparous women are partly attributable to higher-risk women not having a subsequent live birth, either by choice or due to fecundity differences.

Duke Scholars

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Published In

Public Health Rep

DOI

ISSN

0033-3549

Publication Date

2011

Volume

126

Issue

6

Start / End Page

797 / 805

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Factors
  • Public Health
  • Proportional Hazards Models
  • Premature Birth
  • Pregnancy Outcome
  • Pregnancy
  • Parity
  • North Carolina
  • Maternal Age
 

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Miranda, M. L., Edwards, S. E., & Myers, E. R. (2011). Adverse birth outcomes among nulliparous vs. multiparous women. Public Health Rep, 126(6), 797–805. https://doi.org/10.1177/003335491112600605
Miranda, Marie Lynn, Sharon E. Edwards, and Evan R. Myers. “Adverse birth outcomes among nulliparous vs. multiparous women.Public Health Rep 126, no. 6 (2011): 797–805. https://doi.org/10.1177/003335491112600605.
Miranda ML, Edwards SE, Myers ER. Adverse birth outcomes among nulliparous vs. multiparous women. Public Health Rep. 2011;126(6):797–805.
Miranda, Marie Lynn, et al. “Adverse birth outcomes among nulliparous vs. multiparous women.Public Health Rep, vol. 126, no. 6, 2011, pp. 797–805. Pubmed, doi:10.1177/003335491112600605.
Miranda ML, Edwards SE, Myers ER. Adverse birth outcomes among nulliparous vs. multiparous women. Public Health Rep. 2011;126(6):797–805.
Journal cover image

Published In

Public Health Rep

DOI

ISSN

0033-3549

Publication Date

2011

Volume

126

Issue

6

Start / End Page

797 / 805

Location

United States

Related Subject Headings

  • Young Adult
  • Risk Factors
  • Public Health
  • Proportional Hazards Models
  • Premature Birth
  • Pregnancy Outcome
  • Pregnancy
  • Parity
  • North Carolina
  • Maternal Age