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01-10-2011

Maternal Marital Status and Birth Outcomes: A Systematic Review and Meta-Analyses

Authors: Prakesh S. Shah, Jamie Zao, Samana Ali

Published in: Maternal and Child Health Journal | Issue 7/2011

Abstract

Systematically review risks of an infant being born with low birth weight (LBW), preterm birth (PTB) or small for gestational age (SGA) among married and unmarried women. Medline, Embase, CINAHL, and bibliographies of identified articles were searched for English language studies. Studies reporting birth outcomes of married and unmarried (single and cohabitant) were included. Two reviewers independently collected data and assessed the quality of the studies for biases in sample selection, exposure assessment, confounder, analytical, outcome assessments, and attrition. Meta-analyses were performed using random effect model for both unadjusted and adjusted data and odds ratio (OR), and 95% confidence interval (CI) were calculated. Twenty-one studies of low to moderate risk of bias were included. Compared to married mothers unadjusted odds of (a) LBW was increased among unmarried (OR 1.46, 95%CI 1.25–1.71), single (OR 1.65, 95%CI 1.44–1.88) and cohabitating (OR 1.29, 95%CI 1.25–1.32) mothers; (b) PTB was increased among unmarried (OR 1.22, 95%CI 1.14–1.31), single (OR 1.54, 95%CI 1.39–1.72) and cohabitating (OR 1.15, 95%CI 1.08–1.23) mothers and (c) SGA birth was increased among unmarried (OR 1.45, 95%CI 1.32–1.61), single (OR 1.70, 95%CI 1.47–1.97) and cohabitating (OR 1.36, 95%CI 1.30–1.42) mothers. Meta-analyses of adjusted odds estimates confirmed these findings at marginally lower odds. Maternal unmarried status is associated with an increased risk of LBW, PTB and SGA births.

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Blondel, B., & Zuber, M. C. (1988). Marital status and cohabitation during pregnancy: Relationship with social conditions, antenatal care and pregnancy outcome in France. Paediatric and Perinatal Epidemiology, 2(2), 125–137.PubMedCrossRef

Ventural, S. J. (2009). Changing patterns of nonmarital childbearing in the United States. Hyattsville, MD: National Center for Health Statistics; Report No.: NCHS Data Brief, no. 18.

Jose, A., O’Leary, D., & Moyer, A. (2010). Does premarital cohabitation predict subsequent marital stability and marital quality? The Journal of Marriage and Family, 72, 105–116.CrossRef

Bird, S. T., Chandra, A., Bennett, T., & Harvey, S. M. (2000). Beyond marital status: Relationship type and duration and the risk of low birth weight. Family Planning Perspectives, 32(6), 281–287.PubMedCrossRef

Doucet, H., Baumgarten, M., & Infante-Rivard, C. (1989). Low birth weight and household structure. Journal of Developmental and Behavioral Pediatrics, 10(5), 249–252.PubMedCrossRef

Hanke, W., Kalinka, J., & Sobala, W. (1998). Single motherhood, urban residence and SGA babies in Central Poland. International Journal of Gynaecology and Obstetrics, 61(3), 289–291.PubMedCrossRef

Kirchengast, S., Mayer, M., & Voigt, M. (2007). Pregnancy outcome is associated with maternal marital status in Austria–even at the beginning of the 21st century. Anthropologischer Anzeiger, 65(4), 415–426.

Luo, Z. C., Wilkins, R., & Kramer, M. S. (2004). Disparities in pregnancy outcomes according to marital and cohabitation status. Obstetrics and Gynecology, 103(6), 1300–1307.PubMedCrossRef

MacDonald, L. D., Peacock, J. L., & Anderson, H. R. (1992). Marital status: association with social and economic circumstances, psychological state and outcomes of pregnancy. Journal of Public Health Medicine, 14(1), 26–34.PubMed

10.

Vagero, D., Koupilova, I., Leon, D. A., & Lithell, U. B. (1999). Social determinants of birthweight, ponderal index and gestational age in Sweden in the 1920s and the 1980s. Acta Paediatrica, 88(4), 445–453.PubMedCrossRef

11.

Raatikainen, K., Heiskanen, N., & Heinonen, S. (2005). Marriage still protects pregnancy. BJOG : An International Journal of Obstetrics and Gynaecology, 112(10), 1411–1416.CrossRef

12.

Sung, J. F., McGrady, G. A., Rowley, D. L., Hogue, C. J., Alema-Mensah, E., & Lypson, M. L. (1993). Interactive effect of race and marital status in low birthweight. Ethnicity and Disease, 3(2), 129–136.PubMed

13.

Bennett, T. (1992). Marital status and infant health outcomes. Social Science and Medicine, 35(9), 1179–1187.PubMedCrossRef

14.

Stroup, D. F., Berlin, J. A., Morton, S. C., Olkin, I., Williamson, G. D., Rennie, D., et al. (2000). Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. The Journal of the American Medical Association, 283(15), 2008–2012.CrossRef

15.

Higgins, P. T., Green, S. (2008). Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration 2008 [cited 2008 Mar 1]; (Version 5.0.0)Available from: url: www.cochrane-handbook.org.

16.

Higgins, J. P., & Thompson, S. G. (2002). Quantifying heterogeneity in a meta-analysis. Statistics in Medicine, 21(11), 1539–1558.PubMedCrossRef

17.

Ahmed, F. (1990). Unmarried mothers as a high-risk group for adverse pregnancy outcomes. Journal of Community Health, 15(1), 35–44.PubMedCrossRef

18.

Albrecht, S. L., Miller, M. K., & Clarke, L. L. (1994). Assessing the importance of family structure in understanding birth outcomes. Journal of Marriage and the Family, 56, 987–1003.CrossRef

19.

Amini, S. B., Catalano, P. M., & Mann, L. I. (1996). Births to unmarried mothers: trends and obstetric outcomes. Womens Health Issues, 2006, 264–272.CrossRef

20.

Auger, N., Daniel, M., Platt, R. W., Luo, Z. C., Wu, Y., & Choiniere, R. (2008). The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: A retrospective cohort study. BMC Pregnancy Childbirth, 8, 7.PubMedCrossRef

21.

Gale, R., Zengen, S., Harlap, S., Fischer, A. F., & Stevenson, D. K. (1988). Birth out of wedlock and the risk of intrauterine growth retardation. American Journal of Perinatology, 5(3), 278–282.PubMedCrossRef

22.

Golding, J., Henriques, J., & Thomas, P. (1986). Unmarried at delivery. II. Perinatal morbidity and mortality. Early Human Development, 14(3–4), 217–227.PubMedCrossRef

23.

Manderbacka, K., Merilainen, J., Hemminki, E., Rahkonen, O., & Teperi, J. (1992). Marital status as a predictor of perinatal outcome in finland. Journal of Marriage and the Family, 54, 508–515.CrossRef

24.

McIntosh, L. J., Roumayah, N. E., & Bottoms, S. F. (1995). Perinatal outcome of broken marriage in the inner city. Obstetrics and Gynecology, 85(2), 233–236.PubMedCrossRef

25.

Rantakallio, P., & Oja, H. (1990). Perinatal risk for infants of unmarried mothers over a period of 20 years. Early Human Development, 22(3), 157–169.PubMedCrossRef

26.

Zeitlin, J. A., Saurel-Cubizolles, M. J., & Ancel, P. Y. (2002). Marital status, cohabitation, and risk of preterm birth in Europe: Where births outside marriage are common and uncommon. Paediatric and Perinatal Epidemiology, 16(2), 124–130.PubMedCrossRef

27.

Hein, H. A., Burmeister, L. F., & Papke, K. R. (1990). The relationship of unwed status to infant mortality. Obstetrics and Gynecology, 76(5 Pt 1), 763–768.PubMedCrossRef

28.

Kalinka, J., Laudanski, T., Hanke, W., & Wasiela, M. (2003). Do microbiological factors account for poor pregnancy outcome among unmarried pregnant women in Poland? Fetal Diagnosis and Therapy, 18(5), 345–352.PubMedCrossRef

29.

Kiernan, K. (1999). Childbearing outside marriage in western Europe. Population Trends, Autumn(98), 11–20.

30.

Maher, J., Macfarlane, A. (2004). Trends in live births and birthweight by social class, marital status and mother’s age, 1976–2000. Health Statistics Quarterly, Winter(23), 34–42.

31.

Wu, L. L., & Martinson, B. C. (1993). Family structure and risk of premarital birth. American Sociological Review, 58, 210–232.CrossRef

32.

Dickute, J., Padaiga, Z., Grabauskas, V., Nadisauskiene, R. J., Basys, V., & Gaizauskiene, A. (2004). Maternal socio-economic factors and the risk of low birth weight in Lithuania. Medicina (Kaunas), 40(5), 475–482.

33.

Koupilova, I., Vagero, D., Leon, D. A., Pikhart, H., Prikazsky, V., Holcik, J., et al. (1998). Social variation in size at birth and preterm delivery in the Czech Republic and Sweden, 1989–91. Paediatric and Perinatal Epidemiology, 12(1), 7–24.PubMedCrossRef

34.

Lekea-Karanika, V., Tzoumaka-Bakoula, C., & Matsaniotis, N. S. (1999). Sociodemographic determinants of low birthweight in Greece: A population study. Paediatric and Perinatal Epidemiology, 13(1), 65–77.PubMedCrossRef

35.

Pascoe, J. M., Chessare, J., Baugh, E., Urich, L., & Ialongo, N. (1987). Help with prenatal household tasks and newborn birth weight: Is there an association? Journal of Developmental and Behavioral Pediatrics, 8(4), 207–212.PubMedCrossRef

36.

Peacock, J. L., Bland, J. M., & Anderson, H. R. (1995). Preterm delivery: Effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine. British Medical Journal, 311(7004), 531–535.PubMed

37.

Vatten, L. J., & Skjaerven, R. (2003). Effects on pregnancy outcome of changing partner between first two births: Prospective population study. British Medical Journal, 327(7424), 1138.PubMedCrossRef

38.

Ramsey, C. N., Jr, Abell, T. D., & Baker, L. C. (1986). The relationship between family functioning, life events, family structure, and the outcome of pregnancy. Journal of Family Practice, 22(6), 521–527.PubMed

39.

Peters, J., & Mengersen, K. (2008). Selective reporting of adjusted estimates in observational epidemiology studies: Reasons and implications for meta-analyses. Evaluation and the health professions, 31(4), 370–389.CrossRef

Title: Maternal Marital Status and Birth Outcomes: A Systematic Review and Meta-Analyses
Authors: Prakesh S. Shah
Jamie Zao
Samana Ali
Publication date: 01-10-2011
Publisher: Springer US
Published in: Maternal and Child Health Journal / Issue 7/2011
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI: https://doi.org/10.1007/s10995-010-0654-z

ACC 2024 Congress

Springer Medicine

Maternal Marital Status and Birth Outcomes: A Systematic Review and Meta-Analyses

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

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