{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T23:11:22Z","timestamp":1779145882983,"version":"3.51.4"},"reference-count":44,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Adverse pregnancy outcomes (APOs) are major drivers of maternal and child mortality, especially in low-income countries like Ethiopia. Studies examining such inequities from a life course lens are lacking. Hence, this study investigates generational disparities in the risk of APOs.<\/jats:p>\n                  <jats:p>An accelerated cohort design was utilized, recruiting 7,286 women from three birth cohorts (1970s, 1980s, and 1990s) in Kersa, Eastern Ethiopia. A generalized linear mixed-effects model using STATA version 17.0 was used.<\/jats:p>\n                  <jats:p>Pregnancy outcomes varied across generations. Stillbirths were highest in earlier life course (13.8%) and lowest in later (7.3%). Preterm births declined slightly (9.5% to 8.1%), but risks were greater in later life course. Miscarriages were lowest in Cohort 2 (2.9%). Poor maternal nutrition (MUAC &lt;21 cm; AOR = 2.87 for preterm birth, AOR = 1.71 for stillbirth) and high gravidity (AOR = 2.26 for preterm birth, AOR = 1.51 for stillbirth) were strongly associated with adverse pregnancy outcomes, while lack of maternal education (AOR = 1.45) also increased risk of preterm birth. In contrast, later age at first birth (AOR = 0.43 for preterm birth) and higher household wealth (medium AOR = 0.73; highest AOR = 0.63 for preterm birth) were protective factors. These findings underscore the importance of maternal nutrition, reproductive history, and socioeconomic conditions in determining pregnancy outcomes.<\/jats:p>\n                  <jats:p>Generational disparities highlight the need for multilevel strategies addressing social determinants and maternal care. Future studies to elucidate the biological pathways, such as epigenetic changes, linking early-life exposures to pregnancy outcomes are recommended.<\/jats:p>","DOI":"10.1055\/a-2869-3719","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T22:43:08Z","timestamp":1778107388000},"source":"Crossref","is-referenced-by-count":0,"title":["Life Course Perspectives of Adverse Pregnancy Outcomes in Kersa, Eastern Ethiopia: Accelerated Cohort Design"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5682-6117","authenticated-orcid":false,"given":"Afework","family":"Tadele","sequence":"additional","affiliation":[{"name":"Department of Population and Family Health, Jimma University, Jimma, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merga","family":"Dheresa","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery, Haramaya University, Dire Dawa, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muluemebet","family":"Abera","sequence":"additional","affiliation":[{"name":"Department of Population and Family Health, Jimma University, Jimma, Ethiopia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,5,18]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"e1152","DOI":"10.1016\/S2214-109X(20)30315-6","article-title":"Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990-2019","volume":"8","author":"J Bearak","year":"2020","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0140-6736(15)00837-5","article-title":"Stillbirths: Rates, risk factors, and acceleration towards 2030","volume":"387","author":"J E 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