{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:56:36Z","timestamp":1785380196473,"version":"3.55.0"},"reference-count":37,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Parents of very or extremely low birth weight infants have fewer subsequent children after preterm birth. Whether this applies to parents of less preterm infants is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>In this nationwide cohort study, we identified all 230\u2009308 traceable (&amp;gt;99%) singletons (9983 preterm, 4.3%) live born in Finland between January 1, 1987, and September 30, 1990, and their parents. Quantitative contribution of gestational age of child to the birth of parental subsequent children was assessed by multivariate Cox regression models, stratifying by the number of previous children. The impact of gestational age on sibling count was estimated at individual and population level.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>Mothers of extremely preterm (23\u201327 completed weeks) infants were, compared with mothers of term infants (39\u201341 weeks), less likely to have a subsequent live-born child (adjusted hazard ratio [HR]: 0.74; 95% confidence interval: 0.63\u20130.86). Corresponding HRs and confidence intervals were as follows: 28 to 31 weeks: 0.72 (0.65\u20130.80), 32 to 33 weeks: 0.82 (0.74\u20130.90), and 34 to 36 weeks: 0.90 (0.87\u20130.93). These HRs were consistent with those of fathers and couples. The cohort included 8002 firstborn preterm children, of whom 356 (4.4%) died in infancy. The 8002 children had a total of 13\u2009826 subsequent siblings (1138 less than expected); per 1000 preterm births, this translates to the death of 44 preterm infants and 142 missing subsequent siblings.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Families with a preterm singleton child have fewer subsequent children. In a high-income country, the main population effect of preterm birth is caused by these \u201cmissing siblings,\u201d whose number exceeds the number of those preterm infants who die.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2017-1354","type":"journal-article","created":{"date-parts":[[2017,12,15]],"date-time":"2017-12-15T08:30:31Z","timestamp":1513326631000},"source":"Crossref","is-referenced-by-count":14,"title":["The Missing Siblings of Infants Born Preterm"],"prefix":"10.1542","volume":"141","author":[{"given":"Suvi","family":"Alenius","sequence":"first","affiliation":[{"name":"National Institute for Health and Welfare, Helsinki and Oulu, Finland;"},{"name":"Faculty of Medicine, Institute of Clinical Medicine and"},{"name":"Children\u2019s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eero","family":"Kajantie","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Helsinki and Oulu, Finland;"},{"name":"Children\u2019s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;"},{"name":"Faculty of Medicine, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reijo","family":"Sund","sequence":"additional","affiliation":[{"name":"Faculty of Social Sciences, Center for Research Methods, University of Helsinki, Helsinki, Finland;"},{"name":"Faculty of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieta","family":"N\u00e4s\u00e4nen-Gilmore","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Helsinki and Oulu, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"V\u00e4\u00e4r\u00e4sm\u00e4ki","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Helsinki and Oulu, Finland;"},{"name":"Faculty of Medicine, PEDEGO Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Helsinki and Oulu, Finland;"},{"name":"Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petteri","family":"Hovi","sequence":"additional","affiliation":[{"name":"National Institute for Health and Welfare, Helsinki and Oulu, Finland;"},{"name":"Children\u2019s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2018,1,1]]},"reference":[{"issue":"9832","key":"2021121021511905200_B1","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications.","volume":"379","author":"Blencowe","year":"2012","journal-title":"Lancet"},{"issue":"1","key":"2021121021511905200_B2","first-page":"1","article-title":"Births: final data for 2013.","volume":"64","author":"Martin","year":"2015","journal-title":"Natl Vital Stat Rep"},{"issue":"11","key":"2021121021511905200_B3","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1111\/1471-0528.12281","article-title":"Preterm birth time trends in Europe: a study of 19 countries.","volume":"120","author":"Zeitlin","year":"2013","journal-title":"BJOG"},{"issue":"1","key":"2021121021511905200_B4","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.earlhumdev.2004.10.003","article-title":"The fetal, neonatal, and infant environments-the long-term consequences for disease risk.","volume":"81","author":"Gluckman","year":"2005","journal-title":"Early Hum Dev"},{"issue":"5","key":"2021121021511905200_B5","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1067\/mpd.2000.109001","article-title":"Impact of extreme prematurity on families of adolescent children.","volume":"137","author":"Saigal","year":"2000","journal-title":"J Pediatr"},{"key":"2021121021511905200_B6","volume-title":"Preterm Birth: Causes, Consequences, and Prevention","author":"Behrman","year":"2007"},{"issue":"9","key":"2021121021511905200_B7","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1001\/jama.281.9.799","article-title":"Maternal psychological distress and parenting stress after the birth of a very low-birth weight infant.","volume":"281","author":"Singer","year":"1999","journal-title":"JAMA"},{"issue":"2","key":"2021121021511905200_B8","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1001\/archpedi.1995.02170140033005","article-title":"The impact of very low-birth-weight infants on the family is long lasting. 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