ArticleBMJ open2018
Uterine distention as a factor in birth timing: retrospective nationwide cohort study in Sweden.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Genetic effects on the timing of parturition and links to fetal birth weight.Nature genetics · 2023Pooled it
- Cesarean section and the gestational duration of subsequent pregnancies: A nationwide register-based cohort study.PloS one · 2025Article
- Prediction of preterm birth using machine learning: a comprehensive analysis based on large-scale preschool children survey data in Shenzhen of China.BMC pregnancy and childbirth · 2024Article
- Spontaneous preterm birth: Involvement of multiple feto-maternal tissues and organ systems, differing mechanisms, and pathways.Frontiers in endocrinology · 2022Review
- Observational
- Mid-trimester amniotic fluid proteome's association with spontaneous preterm delivery and gestational duration.PloS one · 2020Article
- Comparison of the myometrial transcriptome from singleton and twin pregnancies by RNA-Seq.PloS one · 2020Article
- Large-for-gestational-age fetuses have an increased risk for spontaneous preterm birth.Journal of perinatology : official journal of the California Perinatal Association · 2019Article
- Risk of spontaneous preterm birth and fetal growth associates with fetal SLIT2.PLoS genetics · 2019Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine whether uterine distention is associated with human pregnancy duration in a non-invasive observational setting.
designRetrospective cohort study modelling uterine distention by interaction between maternal height and uterine load.
settingThe study is based on the 1990-2013 population data from all delivery units in Sweden.
participantsUncomplicated first pregnancies of healthy Nordic-born mothers with spontaneous onset of labour. Pregnancies were classified as twin (n=2846) or singleton (n=527 868). Singleton pregnancies were further classified as carrying a large for gestational age fetus (LGA, n=24 286) or small for gestational age fetus (SGA, n=33 780). OUTCOME MEASURES: Statistical interaction between maternal height and uterine load categories (twin vs singleton pregnancies, and LGA vs SGA singleton pregnancies), where the outcome is pregnancy duration.
resultsIn all models, statistically significant interaction was found. Mothers carrying twins had 2.9 times larger positive linear effect of maternal height on gestational age than mothers carrying singletons (interaction p=5e-14). Similarly, the effect of maternal height was strongly modulated by the fetal growth rate in singleton pregnancies: the effect size of maternal height on gestational age in LGA pregnancies was 2.1 times larger than that in SGA pregnancies (interaction p<1e-11). Preterm birth OR was 1.4 when the mother was short, and 2.8 when the fetus was extremely large for its gestational age; however, when both risk factors were present together, the OR for preterm birth was larger than expected, 10.2 (interaction p<0.0005).
conclusionsAcross all classes, maternal height was significantly associated with child's gestational age at birth. Interestingly, in short-statured women with large uterine load (twins, LGA), spontaneous delivery occurred much earlier than expected. The interaction between maternal height, uterine load size and gestational age at birth strongly suggests the effect of uterine distention imposed by fetal growth on birth timing.
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