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We derived <jats:italic>e<\/jats:italic>\u2010values to determine the minimum strength of association for an unmeasured confounding factor to explain away an observed association.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complications in a first pregnancy were associated with an increased risk of a subsequent preterm birth. Relative risks were significantly higher when the complication was recurrent, with the exception of first\u2010term perinatal death. The association with subsequent preterm birth was strongest when pre\u2010eclampsia was recurrent. The risk of subsequent preterm birth with pre\u2010eclampsia was 11.87 (95% CI 9.52\u201314.79) times higher after a first term birth with pre\u2010eclampsia, and 64.04 (95% CI 53.58\u201376.55) times higher after a preterm first birth with pre\u2010eclampsia, than an uncomplicated term birth. The <jats:italic>e<\/jats:italic>\u2010values were 23.22 and 127.58, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The strong associations between recurrent pre\u2010eclampsia, placental abruption and small\u2010for\u2010gestational age with preterm birth supports the hypothesis of shared underlying causes\u2009that persist from pregnancy to pregnancy. High <jats:italic>e<\/jats:italic>\u2010values suggest that recurrent confounding is unlikely, as any such unmeasured confounding factor would have to be uncharacteristically large.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>First pregnancy complications are associated with a higher risk of subsequent preterm birth, with evidence strongest for pregnancies complicated by pre\u2010eclampsia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17007","type":"journal-article","created":{"date-parts":[[2021,11,13]],"date-time":"2021-11-13T03:30:22Z","timestamp":1636774222000},"page":"890-899","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["The role of confounding in the association between pregnancy complications and subsequent preterm birth: a cohort 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