title: Impact of low birthweight on subsequent fertility: population-based register study.
abstract: Adverse birth outcomes may influence a family's wish for additional children. We investigated the influence of low birthweight in live births on subsequent fertility, and estimated secular trends of such an effect in a population-based cohort study of births arranged in consecutive sibship records in the Medical Birth Registry of Norway. We included births of order one to seven to all 587 785 mothers in Norway who had a first singleton birth in 1967-91. Associations between birthweight in 1 158 072 surviving index births of order one to six, 1967-91, and subsequent fertility (probability of another birth), 1967-97, were estimated as fertility ratios in Cox regression analysis. Giving birth to a live infant weighing < 3000 g had a negative effect on subsequent fertility, increasingly strong for decreasing birthweight. Low birthweight (<2500 g) was associated with a fertility ratio of 0.88 [95% confidence interval 0.87, 0.89]. This negative impact was stronger if the mother had also given birth to surviving children of low birthweight previously, particularly if combined with caesarean section in the most recent birth. The negative fertility effect of low birthweight grew slightly stronger between 1967 and approximately 1980, according to year of first birth. This trend paralleled reduced population fertility in the same period. The moderate negative impact of giving birth to a live infant of low birthweight on subsequent fertility could result from the combination of reduced wish for additional children and biological subfertility.
authors.affiliation: National Institute of Occupational Health, Oslo, Medical Birth Registry of Norway, University of Bergen, Norway. petter.kristensen@stami.no
authors.forename: Petter
authors.initials: P
authors.lastname: Kristensen
authors.forename: Lorentz M
authors.initials: LM
authors.lastname: Irgens
authors.forename: Tor
authors.initials: T
authors.lastname: Bjerkedal
mesh_terms: D005260:Female; D005298:Fertility; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010298:Parity; D011247:Pregnancy; D011336:Probability; D012042:Registries; D012044:Regression Analysis