Vatten Lars J, Skjaerven Rolv
Institutt for samfunnsmedisinske fag, Norges teknisk-naturvitenskapelige universitet, 7489 Trondheim.
Tidsskr Nor Laegeforen. 2003 Dec 23;123(24):3546-8.
Childbearing with different fathers has increased in western societies because of the higher frequency of divorce and remarriage. Pregnancy outcomes may differ between mothers who have changed partner between first and second birth and mothers who have the same father for both births. Women who change partner may have individual characteristics that increase risk of adverse outcomes, but change of partner could also be associated with unfavourable changes in behaviour.
The Medical Birth Registry of Norway was established in 1967 and includes information on approximately 1.8 million births until 1998. Both parents are recorded. We have compared pregnancy outcomes for 30 176 mothers who changed partner between first and second birth and 461 154 mothers who had the same partner for both births.
In relation to the first birth, the risk of adverse pregnancy outcomes was not clearly different between mothers who later had a second birth with another partner and mothers who had the same partner for both births. Offsprings of mothers who changed partner between first and second birth were at higher risk of infant mortality (relative risk 1.5, 95 % confidence interval, 1.3-1.7), preterm birth (< 37 weeks; relative risk 1.3, 95 % confidence interval, 1.2-1.4), and low birth weight (< 2500 gram; relative risk 1.5, 95 % confidence interval, 1.4-1.6), after adjustment for maternal age and level of education, interval between births, and time period.
Mothers who change partner between first and second birth are at increased risk of having a preterm, low birth weight baby with increased risk of infant death for the second child compared to mothers who have the same partner for both births.
由于离婚和再婚的频率增加,西方社会中与不同父亲生育的情况有所增多。头胎和二胎有不同伴侣的母亲与两胎都有相同父亲的母亲相比,妊娠结局可能存在差异。更换伴侣的女性可能具有增加不良结局风险的个体特征,但更换伴侣也可能与行为上的不利变化有关。
挪威医学出生登记处成立于1967年,包含了截至1998年约180万例出生的信息。父母双方信息均有记录。我们比较了30176名头胎和二胎有不同伴侣的母亲与461154名头胎和二胎都有相同伴侣的母亲的妊娠结局。
与头胎相比,头胎后与另一伴侣生育二胎的母亲和两胎都有相同伴侣的母亲,不良妊娠结局的风险并无明显差异。在对母亲年龄、教育水平、两次生育间隔以及时间段进行调整后,头胎和二胎有不同伴侣的母亲所生子女的婴儿死亡率(相对风险1.5,95%置信区间,1.3 - 1.7)、早产(<37周;相对风险1.3,95%置信区间,1.2 - 1.4)和低出生体重(<2500克;相对风险1.5,95%置信区间,1.4 - 1.6)风险更高。
与两胎都有相同伴侣的母亲相比,头胎和二胎有不同伴侣的母亲生育早产、低出生体重婴儿的风险增加,且第二个孩子的婴儿死亡风险也增加。