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Out-of-Home Care and Subsequent Preterm Delivery: An Intergenerational Cohort Study
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS). Karolinska Institutet, Sweden.ORCID iD: 0000-0003-2580-7903
Stockholm University, Faculty of Social Sciences, Department of Social Work.
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
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Number of Authors: 72018 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 142, no 2, article id e20172729Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Adverse early-life experience may affect preterm delivery later in life through priming of stress response. We aim to investigate the links between out-of-home care (OHC) experience in childhood, as a proxy of severe adversities, on subsequent risk of preterm delivery. METHODS: A register-based national cohort of all women born in Sweden between 1973 and 1977 (N = 175 821) was crosslinked with information on these women's subsequent deliveries as recorded in the Swedish medical birth register. During 1986-2012, 343 828 livebirths of these women were identified. The associations between women's OHC experience and her risk of preterm delivery were analyzed through logistic regression models, adjusting for women's own preterm birth, intrauterine growth, and childhood socioeconomic situation. RESULTS: Compared with women that never entered OHC, women with OHC experience up to and after age 10 were both associated with increased risks of preterm delivery (adjusted odds ratio [aOR] = 1.23 [95% confidence interval 1.08-1.40] and aOR = 1.29 [1.13-1.48], respectively). Women who experienced OHC before or at 10 years of age had increased risk of both spontaneous and medically indicated preterm delivery (aOR = 1.19 [1.03-1.38] and aOR = 1.27 [1.02-1.59], respectively). Women who experienced OHC after age 10 had a more pronounced risk of medically indicated preterm delivery (aOR = 1.76 [1.44-2.16]) than for spontaneous preterm delivery (aOR = 1.08 [0.92-1.27]). CONCLUSIONS: Women who were placed in OHC in childhood had increased risk of preterm delivery independent from their own perinatal history. Stress response, as 1 consequence of early life adversities, may take its toll on women's reproductive health and their offspring, calling for integrative efforts in preventing early life adversity.

Place, publisher, year, edition, pages
2018. Vol. 142, no 2, article id e20172729
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Public Health, Global Health, Social Medicine and Epidemiology
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URN: urn:nbn:se:su:diva-159003DOI: 10.1542/peds.2017-2729ISI: 000440459900005PubMedID: 30021856OAI: oai:DiVA.org:su-159003DiVA, id: diva2:1246769
Available from: 2018-09-10 Created: 2018-09-10 Last updated: 2018-09-10Bibliographically approved

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Liu, CanVinnerljung, BoÖstberg, VivecaGauffin, KarlJuarez, SolHjern, Anders
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Centre for Health Equity Studies (CHESS)Department of Social Work
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