{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:59:07Z","timestamp":1790776747905,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hypertensive disorders of pregnancy (HDP) are a leading reason for medically indicated preterm birth (PTB), yet their contribution to population\u2010level PTB trends is poorly understood. We examined temporal trends in PTB overall and HDP\u2010associated PTB in Victoria over an 11\u2010year period spanning the COVID\u201019 pandemic, and distinguished changes in HDP prevalence from changes in preterm delivery among affected pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Population\u2010based interrupted time\u2010series study using seasonal autoregressive integrated moving average (SARIMA) models, with July 2018 (launch of a national preterm birth prevention program) pre\u2010specified as a temporal reference point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>All hospitals in Victoria, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>779,325 singleton births at \u2265\u200920\u2009weeks' gestation between 1 January 2012 and 31 March 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Monthly rates (per 1000 singleton births) of overall PTB, HDP and HDP\u2010associated PTB. Decomposition analyses separated changes in HDP prevalence from changes in preterm delivery among affected pregnancies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall PTB was lower after July 2018 (5.8%\u20135.6%), while HDP prevalence increased (6.4%\u20137.0%). HDP\u2010associated PTB increased before mid\u20102018 (+0.75 per 1000 births per month; 95% confidence interval [CI], 0.50\u20131.00) but declined thereafter (\u22121.12 per 1000 births per month; 95% CI, \u22121.88 to \u22120.36). This reversal was driven predominantly by reduced iatrogenic PTB with HDP; spontaneous PTB with HDP showed no significant change. Despite rising HDP prevalence, decomposition analyses estimated 89 fewer HDP\u2010associated PTB cases than expected under pre\u20102018 patterns, reflecting a decline in the proportion of HDP pregnancies delivered preterm. PTB without HDP showed no significant temporal change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PTB among HDP\u2010complicated pregnancies declined despite increasing HDP prevalence, consistent with a shift towards later gestational age at delivery rather than reduced disease incidence. These findings may reflect improvements in care and demonstrate that reductions in iatrogenic PTB are achievable even as major risk factors become more prevalent.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70267","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:14:22Z","timestamp":1787584462000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends in Preterm Birth Associated With Hypertensive Disorders of Pregnancy in Victoria, Australia: A Population\u2010Based Interrupted Time\u2010Series Study"],"prefix":"10.5694","volume":"224","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2696-7335","authenticated-orcid":false,"given":"Melvin","family":"Marzan","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Newborn Health University of Melbourne  Heidelberg Victoria Australia"},{"name":"Reproductive Epidemiology Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Mercy Perinatal Mercy Hospital for Women  Heidelberg Victoria Australia"},{"name":"National Centre for Register\u2010Based Research Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Jiang","sequence":"additional","affiliation":[{"name":"School of Psychology and Public Health La Trobe University  Melbourne Victoria Australia"},{"name":"Centre for Health Equity, School of Population and Global Health University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2263-3592","authenticated-orcid":false,"given":"Daniel Lorber","family":"Rolnik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Monash University  Clayton Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology Monash Health  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne M.","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Newborn Health University of Melbourne  Heidelberg Victoria Australia"},{"name":"Department of Maternal Fetal Medicine Joan Kirner Women's and Children's, Sunshine Hospital  St Albans Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9720-3562","authenticated-orcid":false,"given":"Lisa","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Newborn Health University of Melbourne  Heidelberg Victoria Australia"},{"name":"Reproductive Epidemiology Murdoch Children's Research Institute  Parkville Victoria Australia"},{"name":"Mercy Perinatal Mercy Hospital for Women  Heidelberg Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology Northern Health  Epping Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)00878-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13171"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.05.021"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60074-4"},{"key":"e_1_2_12_6_1","volume-title":"Australia's Mothers and Babies","author":"Australian Government, Australian Institute of Health and Welfare","year":"2024"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14049"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704559"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12399"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.26093"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.preghy.2022.02.006"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanogw.2025.100042"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13328"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.006"},{"key":"e_1_2_12_15_1","volume-title":"ICD\u201010\u2010AM\/ACHI\/ACS Tenth Edition","author":"Australian Government, Independent Hospital Pricing Authority","year":"2017"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2016.11.1037"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"issue":"1","key":"e_1_2_12_18_1","first-page":"348","article-title":"Interrupted Time Series Regression for the Evaluation of Public Health Interventions: A Tutorial","volume":"46","author":"Bernal J. 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