{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T08:43:46Z","timestamp":1791276226216,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,5,2]],"date-time":"2013-05-02T00:00:00Z","timestamp":1367452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterise changing risk factors of preterm birth in Western Australia between 1984 and 2006.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Population\u2010based study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Western Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>All non\u2010Aboriginal women giving birth to live singleton infants between 1984 and 2006.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Multinomial, multivariable regression models were used to assess antecedent profiles by preterm status and labour onset types (spontaneous, medically indicated, prelabour rupture of membranes [<jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content>]). Population attributable fraction (<jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content>) estimates characterized the contribution of individual antecedents as well as the overall contribution of two antecedent groups: pre\u2010existing medical conditions (including previous obstetric history) and pregnancy complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measure<\/jats:title><jats:p>Antecedent relationships with preterm birth, stratified by labour onset type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Marked increases in maternal age and primiparous births were observed. A four\u2010fold increase in the rates of pre\u2010existing medical complications over time was observed. Rates of pregnancy complications remained stable. Multinomial regression showed differences in antecedent profiles across labour onset types. <jats:styled-content style=\"fixed-case\">PAF<\/jats:styled-content> estimates indicated that 50% of medically indicated preterm deliveries could be eliminated after removing six antecedents from the population; estimates for <jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content> and spontaneous preterm reduction were between 10 and 20%. Variables pertaining to previous and current obstetric complications (previous preterm birth, previous caesarean section, pre\u2010eclampsia and antepartum haemorrhage) were the most influential predictors of preterm birth and adverse labour onset (<jats:styled-content style=\"fixed-case\">PROM<\/jats:styled-content> and medically indicated).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Preterm antecedent profiles have changed markedly over the 23\u00a0years studied. Some changes may be attributable to true change, others to advances in surveillance and detection. Still others may signify change in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12188","type":"journal-article","created":{"date-parts":[[2013,5,2]],"date-time":"2013-05-02T21:05:11Z","timestamp":1367528711000},"page":"1051-1060","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Changes in risk factors for preterm birth in <scp>W<\/scp>estern <scp>A<\/scp>ustralia 1984\u20132006"],"prefix":"10.1111","volume":"120","author":[{"given":"G","family":"Hammond","sequence":"first","affiliation":[{"name":"Telethon Institute for Child Health Research Centre for Child Health Research The University of Western Australia Perth WA Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Langridge","sequence":"additional","affiliation":[{"name":"Telethon Institute for Child Health Research Centre for Child Health Research The University of Western Australia Perth WA 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