Spontaneous preterm delivery in primiparous women at low risk in Denmark: population based study

doi:10.1136/bmj.38751.524132.2F

BMJ, doi: 10.1136/bmj.38751.524132.2F, (Published 23 February 2006)

RESEARCH

Spontaneous preterm delivery in primiparous women at low risk in Denmark: population based study

Jens Langhoff-Roos ¹^*, Ulrik Kesmodel ², Bo Jacobsson ³, Steen Rasmussen ⁴, Ida Vogel ⁵

¹ Juliane Marie Centre, Department of Obstetrics, Rigshospitalet, DK-2100 Copenhagen, Denmark
² NANEA at the Institute of Public Health, Department of Epidemiology, University of Aarhus, DK-8000, Denmark
³ Perinatal Centre, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, SE-41345 Gothenburg, Sweden
⁴ National Board of Health, Health Statistics, DK-2300 Copenhagen
⁵ Department of Clinical Genetics, Aarhus University Hospital

^* Correspondence to: jlr{at}dadlnet.dk.

Objectives To analyse trends in preterm delivery and the factorscontributing to preterm delivery in Denmark. To construct astandard population at low risk (white European, 20-40 yearsof age, with a singleton spontaneous pregnancy) and describethe changes in this population so that time trends can be comparedinternationally.

Design Population based study.

Participants 99.8%of all deliveries in Denmark, 1995-2004.

Main outcome measuresProportion of babies born at less than 37 weeks' completed gestationfor each year in the overall population and in a standard populationat low risk.

Results Overall, the proportion of preterm deliveriesincreased by 22% from 1995 to 2004. During the same period,known risk factors for preterm delivery such as in vitro fertilisation,multiple pregnancies, and elective deliveries also increased,and logistic regression analyses showed that these factors wereassociated with an increased risk of preterm delivery. Spontaneouspreterm deliveries in primiparous women at low risk rose 51%(from 3.8% to 5.7%) during this time compared with 20% (2.7%to 3.2%) in multiparous women at low risk.

Conclusions The overallproportion of preterm deliveries increased significantly from1995 to 2004 and primiparity and multiple birth were the mostimportant contributing factors. The rise in spontaneous pretermdeliveries in the standard population of primiparous women atlow risk was greater than in the total population.

(Accepted 30 January 2006)

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