妊娠期高血压疾病与小于胎龄儿的关联研究

目的了解河北5县妊娠期高血压疾病(HDCP)和小于胎龄儿(SGA)的发病情况,探讨妊娠期高血压疾病及其严重程度、发病时间和亚型与小于胎龄儿的关系。方法利用2006—2009年中美预防出生缺陷和残疾合作项目在河北5个县开展的"孕期营养项目"的数据。以早产和足月进行分层分析,并将HDCP按照亚型、严重程度和发病时间分组分析。采用χ~2检验进行各组SGA发生率的比较得到相对危险度(RR),采用非条件logistic回归进行多因素分析,得到比值比(OR)和95%置信区间(95%CI)。结果在17 262例孕产妇中,发生HDCP共1 207例,发生率为7.0%;子代发生SGA共1 238例,发生率为7.2%。HDCP组发生SGA的RR值为1.17(0.94,1.45)。以早产和足月分层后,早产孕产妇中HDCP组的发生SGA的RR值为7.94(3.14,20.03),足月孕产妇HDCP组SGA发生率与非HDCP组相比差异无统计学意义。用多因素分析控制孕产妇年龄、BMI、职业、民族、文化程度、孕次、孕检次数、早产、吸烟情况、增补微量营养素分组后,HDCP组、妊娠诱发高血压组、重度HDCP组、早发型HDCP组发生SGA的OR值分别为1.31(1.06,1.63)、1.29(1.03,1.62)、3.63(2.00,6.58)和1.86(1.13,3.07)。结论 HDCP是SGA的危险因素,HDCP的严重程度越大、发病时间越早,越容易娩出SGA,但慢性高血压与SGA发生不相关;HDCP会导致早产儿发生SGA,但不影响足月产儿。应预防HDCP,给予患HDCP的孕产妇合理健康指导,加强围产期监测和干预,减少SGA的发生。     

孕妇生殖道支原体寄居与异常围生结局关系的前瞻性研究

目的探索孕妇生殖道支原体寄居与异常围生结局的病因学关系.方法选择进行围生期保健孕妇739例,根据支原体检测结果将其分成支原体阳性孕妇队列和支原体阴性孕妇队列,随访至围生期结束,比较2组异常围生结局发生率.结果支原体阳性孕妇队列中早产产后热、产褥感染及胎儿宫内窘迫的发生率高于支原体阴性孕妇队列(P＜0.05).分析不同支原体寄居与异常围生结局关系,发现解脲脲原体主要引起早产(RR=3.28,95%CI为1.75～6.14)和胎儿宫内窘迫(RR=3.61,95%CI为1.56～8.33)发生率增加;人型支原体主要导致新生儿肺炎(RR=5.16,95%CI为1.99～13.38)、产后热(RR=5.91,95%CI为2.0～17.42)和产褥感染(RR=4.14,95%CI为1.79～9.6)等异常围生结局发生率的增加.支原体混合寄居表现出协同效应.结论围生期孕妇生殖道支原体寄居能引起异常围生结局发生率的增加,应大力加强对孕妇支原体寄居的防治工作.     

孕期打鼾的相关危险因素分析

目的 分析孕妇打鼾的危险因素,探讨孕妇孕期打鼾的遗传倾向,为预防孕期打鼾提供科学依据.方法 选择2006年1月至2008年2月在温州医学院附属二院住院分娩的孕妇共601人,将孕妇分为打鼾组和非打鼾组,比较两组临床资料.结果 打鼾组年龄、身体质量指数(BMI)、孕期体重增加均显著高于非打鼾组(t值分别为2.453、2.592、2.603,均P＜0.05),妊娠期高血压疾病(PIH)和早产的发生率均显著高于非打鼾组(x2值分别为24.684、16.230,均P＜0.05).Logistic回归分析显示,孕妇打鼾的危险因素分别为吸烟(OR=8.821,P＜0.05),过敏性鼻窦炎(OR=2.125,P＜0.05)、家族打鼾史(OR=1.617,P＜0.05).结论 吸烟、过敏性鼻窦炎、家族打鼾史是孕妇孕期打鼾的危险因素.孕期打鼾会增加妊娠期高血压疾病和早产的发生率.     

基于孕前体重指数分层的早产发生率及其关联因素分析

目的分析基于孕前体重指数(BMI)分层的早产发生率, 探究各BMI层级孕妇发生早产的关联因素。方法选择2018年2月至2020年12月在首都医科大学附属北京妇产医院进入"中国出生人口队列研究"的单胎妊娠孕妇为研究对象。采用电子数据采集系统及标准结构化问卷收集孕妇孕前、孕期及分娩相关数据。根据孕前BMI将孕妇分为偏瘦组、正常组及超重组, 采用Cox比例风险回归模型, 分析不同孕前BMI孕妇早产的关联因素。结果共纳入27 195例单胎活产孕妇, 其早产发生率为5.08%(1 381/27 195), 偏瘦组、正常组及超重组的早产发生率分别为4.29%(138/3 219)、4.63%(852/18 390)和7.00%(391/5 586), 差异有统计学意义(P<0.001)。调整相关因素后, Cox比例风险回归模型显示, 孕前超重组孕妇早产发生的风险是正常体重组孕妇的1.457倍(95%CI:1.292～1.643)。子痫前期-子痫是孕前偏瘦孕妇早产发生的关联因素(HR=2.701, 95%CI:1.318～5.537);高龄(HR=1.232, 95%CI:1.054～1.44...     

孕妇孕期被动吸烟对母体血浆P-LAP、IL-6及IL-10的影响

目的 探讨孕期被动吸烟母体胎盘亮氨酸氨基肽酶(P-LAP)、白介素(IL-6)及IL-10在正常孕妇和早产孕妇血浆中的变化趋势,并分析其对早产的影响.方法 选取175例早产孕妇(28 ～ 36+6周)为研究组(早产组),根据有无被动吸烟分为早产被动吸烟组(n=96)和早产非被动吸烟组(n=79);同时选取177例足月孕妇为对照纽(足月组),同样根据妊娠期被动吸烟情况,分为足月被动吸烟组(n=78)和足月非被动吸烟组(n=99).采用酶联免疫吸附法,测定以上各组孕妇在相应孕周时的血浆P-LAP、IL-6和IL-10浓度.结果 早产被动吸烟组孕妇血浆P-LAP、IL-6和IL-10浓度与足月被动吸烟组比较差异有统计学意义(tP-LAP=3.678、tIL-6=3.865、tIL-10=2.114,均P＜0.05),早产被动吸烟组孕妇血浆P-LAP、IL-6及IL-10浓度与早产非被动吸烟组比较差异有统计学意义(tP-LAP=4.479、tIL-6=4.556、tIL-10=2.202,均P＜0.05);而足月被动吸烟组孕妇血浆P-LAP、IL-6及IL-10浓度与足月非被动吸烟组比较差异无统计学意义(tP-LAP=1.170、tIL-6=1.722、tIL-10=1.423,均P＞0.05).结论孕期被动吸烟可致孕妇P-LAP和IL-10水平降低,IL-6水平升高,引起早产分娩启动,可能是引起孕期被动吸烟孕妇早产发生的关键因素.     

孕期轻度贫血与18月龄儿童发育迟缓关联及其孕妇智商调节作用出生队列研究

目的探讨孕中、孕晚期轻度贫血对18月龄儿童发育行为的影响,阐明孕妇智商水平的调节作用。方法选取2013年5月—2014年9月在安徽省马鞍山市妇幼保健院进行产检的2 826对母婴为研究对象,采用多因素logistic回归模型分析孕期贫血与儿童发育迟缓的关联。结果孕中期和孕晚期轻度贫血检出率分别为27.1%、26.0%。控制混杂因素后,与非贫血孕妇分娩的儿童相比,孕中期轻度贫血是儿童沟通能区发育迟缓的危险因素(RR=2.65,95%CI=1.35～5.19),孕晚期轻度贫血是儿童个人–社会能区发育迟缓的危险因素(RR=2.15,95%CI=1.24～3.73)。按孕妇智力分层,调整混杂因素后,与非贫血孕妇分娩的儿童相比,孕妇智力正常组孕中期轻度贫血(RR=3.61,95%CI=1.50～8.72)和孕中、晚期都轻度贫血(RR=2.60,95%CI=1.01～6.69)是儿童沟通能区发育迟缓的危险因素;孕晚期轻度贫血是儿童个人–社会能区发育迟缓的危险因素(RR=2.04,95%CI=1.05～3.95)。孕妇智力低下组孕期轻度贫血与儿童发育迟缓的关联无统计学意义。结论孕中、晚期轻度贫血可损害18月龄幼儿沟通和个人–社会能区的发育,孕妇智商水平起调节作用。     

不同出生胎龄的2～7岁小于胎龄儿生长激素释放多肽、胰岛素样生长因子-1、胰岛素水平及其与生长发育的关系

目的探讨生长激素释放多肽(Ghrelin)、胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、胰岛素在小于胎龄儿(SGA)生长发育中的作用。方法分别检测2～7岁早产SGA、足月SGA血Ghrelin、IGF-1、IGFBP-3、胰岛素、血糖的水平,并与相应的早产AGA、足月AGA进行比较,并做相关性分析。结果 Ghrelin在早产SGA组高于足月SGA(P<0.05),与早产AGA无明显差异,早产AGA高于足月AGA(P<0.05),足月SGA高于足月AGA(P<0.01)。IGF-1和IGFBP-3水平在早产SGA组低于足月SGA(P<0.05),早产AGA组明显低于足月AGA组(P<0.0001)。胰岛素水平在足月SGA组最高。胰岛素抵抗指数(IRI)在各组间比较与胰岛素结果一致。早产SGA组与足月SGA组中Ghrelin与各项指标的相关分析显示:Ghrelin与体重标准差计分(SDS)、IGF-1、IGFBP-3、胰岛素及IRI呈负相关,早产SGA组分别为(r=-0.683,P<0.002;r=-0.749,P<0.001;r=-0.828,P<0.001;r=-0.694,P<0.005;r=-0.822,P<0.001),足月SGA组分别为(r=-0.792,P<0.001;r=-0.707,P<0.002;r=-0.615,P<0.01;r=-0.648,P<0.005;r=-0.679,P<0.005)。结论 Ghrelin参与了早产儿和SGA儿生后的生长发育过程,但与追赶生长程度的关系不大。Ghrelin作为胰岛素的反调节因子,以负反馈的形式调节能量代谢。     

绒毛膜羊膜炎早产子宫平滑肌、胎膜表皮生长因子受体的表达

目的 考察绒毛膜羊膜炎早产子宫平滑肌、胎膜上表皮生长因子受体(EGFR)的表达变化.方法 早产(28～36周妊娠)患者60例,根据分娩后送检胎盘病理有无绒毛膜羊膜炎分为早产合并绒毛膜羊膜炎组即早产感染组孕妇30例,早产无合并绒毛膜羊膜炎组即早产非感染组孕妇30例,对照组为同期正常足月产(37 ～41周妊娠)孕妇30例;各组均行剖宫产,均在术前取子宫下段平滑肌和胎膜,利用免疫组织化学染色法结合图象分析技术检测临产后EGFR在子宫平滑肌、胎膜上的表达.结果 早产感染组孕妇子宫平滑肌细胞、胎膜细胞EGFR表达显著高于早产非感染组和正常足月组,差异均有显著性(P＜0.01);早产非感染组孕妇EGFR水平虽高于正常足月组,但差异无显著性(P＞0.05).结论 绒毛膜羊膜炎能引起孕妇子宫平滑肌、胎膜细胞EGFR表达显著升高.     

孕中期血红蛋白水平与妊娠高血压疾病的关系

目的 分析孕中期血红蛋白水平(Hb)与孕晚期妊娠高血压疾病(PIH)之间的关系. 方法 比较1995～2000年浙江省和江苏省4个县(市)单胎分娩的95 620例妇女孕中期不同Hb水平孕妇的PIH发病率;采用loglstic回归模型控制年龄、职业、文化程度、产次和体质指数(BMI)等因素后,估计Hb水平与PIH之间的关联程度. 结果 孕晚期及产时孕妇PIH的发病率为9.7%;Hb水平为100～109 g/L时,PIH的发病率最低;Hb水平升高或者降低,PIH的发病率均呈增加趋势,Hb<80 g/L的孕妇PIH的发病风险增加79%(OR=1.79,95%CI:1.29～2.49),Hb≥150 g/L的孕妇PIH的发病风险增加47%(OR=1.47,95%CI:1.00～2.21). 结论 孕中期Hb水平与PIH的发生风险之间呈"U"型关系,重度贫血以及高水平Hb都可能会增加PIH的发生风险.     

孕妇体质量指数及孕期增重对妊娠结局的影响

目的 研究孕妇孕妇体质量指数及其孕期增重对妊娠结局的影响.方法 选取2005～2008年在本院分娩符合标准的孕妇1 897例,根据不同的孕妇体质量指数分为3组,根据孕期体重增大的不同幅度分为3组,比较各组的剖宫产率、新生儿窒息率、巨大儿发生率、产后出血率、早产率、低体重儿发生率.结果 超重组的剖宫产率(36.04% vs 28.03%)、巨大儿发生率(10.41% vs 6.83%)、新生儿窒息率(8.63% vs 2.89%)、早产(5.33% vs 2.09%)、低出生体重(4.82% vs 2.49%)均高于正常体重组(均P<0.05),消瘦组早产、低出生体重发生率高于正常体重组(6.59% vs 2.09%,5.43% vs 2.49%,均P<0.05).孕期体重增长过多或者增重不足组妊娠结局明显差于增重合适组(P<0.05).增重过多组剖宫产、新生儿窒息、早产、低出生体重发生率约为增重合适组的2倍[OR分别为1.82(95%CI 1.47～2.26),2.34(95%CI 1.43～3.84),2.20(95%CI 1.25～3.86)1.92(95%CI 1.06～3.47),均P<0.05].结论 孕妇体重指数、孕期体重增长的增幅对分娩结局有影响,孕前保持正常体重、孕期合理营养控制适宜的体重增长有利于取得理想的分娩结局.     

妊高征与小于胎龄儿的相关性研究

目的:探讨妊高征与小于胎龄儿(SGA)之间的联系。方法:选取2000年1月~2004年10月在本院出生的单胎活产SGA病例共834例(男443例,女391例)作为病例组。以胎儿性别及出生孕周进行频数匹配,按1∶3的比例,采用完全随机抽样方法选取出生体重在10%~90%分位的适于胎龄儿2 502例(男1 329例,女1 173例)为对照组,比较病例组及对照组新生儿母亲孕期患妊高征的比例。结果:①病例组母亲患轻度、中度及重度妊高征比例分别是对照组的2.52(95%C I,1.35~4.69)、4.21(2.03~8.70)和5.15(3.10~8.54)倍;②分层分析表明,男性及女性病例组母亲妊高征的患病比例分别是对照组的4.45(2.72~7.27)和3.51(2.14~5.75)倍,男性及女性病例组母亲妊高征的患病优势比无显著差异,早产和足月病例组母亲患妊高征的比例分别为对照组的9.96(4.50~22.02)和3.21(2.15~4.78)倍,早产病例组母亲妊高征的患病优势比显著高于足月病例组;③校正性别、足月与否及母亲年龄的多因素分析结果与单因素分析结果类似。结论:妊高征可显著增加SGA发病的危险性。     

Maternal coffee drinking in pregnancy and risk of small for gestational age birth

OBJECTIVE: We have analysed the association between coffee drinking before and during the three trimesters of pregnancy and risk of small for gestational age (SGA) birth. METHODS: Cases were 555 women who delivered SGA births (ie <10th percentile according Italian standard). The controls included 1966 women who gave birth at term (>/=37 weeks of gestation) to healthy infants of normal weight. RESULTS: In comparison with nondrinkers, the ORs for SGA birth were 1.3 (95% confidence interval, CI, 0.9-1.9) for consumption of four or more cups of coffee/day before pregnancy, and 1.2 (95% CI 0.8-1.8), 1.2 (95% CI 0.8-1.8) and 0.9 (95% CI 0.6-1.4) for consumption of three or more cups of coffee/day during the first, second and third trimester of pregnancy, respectively. CONCLUSION: These findings were consistent in women who delivered preterm and at term births and were not affected by potential confounding such as smoking.     

Coffee drinking and risk of preterm birth

OBJECTIVES: We analysed the association between coffee drinking before and during the three trimesters of pregnancy and the risk of preterm birth of babies normal for gestational age (NGA) or small for gestational age (SGA). METHODS: Case-control study conducted in University clinics of North Italy. Cases were 502 women who delivered at <37 weeks of gestation. The controls included 1966 women who gave birth at term (>or=37 weeks of gestation) to healthy infants on randomly selected days at the hospitals where cases had been identified. RESULTS: There was inverse association for coffee consumption in the third trimester of pregnancy in SGA cases compared to NGA (heterogeneity test between OR: chi1(2)=5.6811 P<0.05). In comparison with not drinkers, all the ORs of overall intake of caffeine were closed near the unity for both SGA and NGA preterm birth. CONCLUSION: Compared with no consumption, a low consumption of coffee during pregnancy may not have significant effects on preterm birth.     

Does inadequate prenatal care contribute to growth retardation among second-born African-American babies?

The authors evaluated the relation between adequacy of prenatal care and risk of delivery of full term small-for-gestational-age (SGA) infants. Data were derived from maternally linked birth certificates for 6,325 African-American women whose first two pregnancies ended in singleton, full term live births in Georgia from 1989 through 1992. The authors used stratified analysis to assess the effect of prenatal care on the risk of having an SGA baby in the second pregnancy among women with and without an SGA baby in their first pregnancy. The group of women with a history of SGA birth may be more likely to include persons for whom SGA delivery is related to factors, such as genetics, that are not amenable to intervention by prenatal care. Inadequate prenatal care was not associated with the risk of SGA delivery among women who had previously delivered an SGA baby. In unadjusted analyses, inadequate prenatal care was associated with an increased risk of delivering a full term SGA baby in the second pregnancy among women whose first baby was not SGA (risk ratio = 1.28; 95% confidence interval: 1.05, 1.55). The association did not persist when data were adjusted for confounding variables (odds ratio = 1.11; 95% confidence interval: 0.89, 1.38). Regardless of outcome in the first pregnancy, adequate prenatal care did not reduce the risk of full term SGA birth among second pregnancies in this population.     

妊娠高血压综合征与早产、低出生体重关系队列研究

目的 探讨妊娠高血压综合征(简称妊高征)与早产、低出生体重的关系.方法 利用131 867名单胎儿母亲的围产保健监测数据,根据妊娠期是否发牛妊高征,建立队列(妊高征组14 278例、非妊高征组117 589名).妊高征根据病情分为轻度、中度和重度组,根据发病时间又分为产时、孕晚期和孕中期发病组.结局指标是早产和低出生体重.应用logistic回归模型调整混杂因素,估计相对危险度和95%可信区间.结果 妊高征组早产、低出生体重发生率分别为4.9%(701/14 278)、3.6%(507/14 278),非妊高征组分别为3.4%(4031/117 589)、1.8%(2110/117 589),两组差异均有统计学意义(X~2值分别为80.8和202.0,P值均<0.001).轻、中和重度妊高征组早产发生率依次为3.9%(404/10 358)、5.8%(181/3099)和14.1%(116/821),低出生体重发生率依次为2.5%(258/10 358)、4.9%(151/3099)和11.9%(98/821),线性趋势检验均具有统计学意义(X~2值分别为196.4和426.1,P值均<0.001).产时、孕晚期和孕中期发病组早产发生率依次为4.2%(373/8813)、5.7%(278/4867)和8.4%(50/598),低出生体重发生率依次为3.0%(267/8813)、4.2%(206/4867)和5.7%(34/598),线性趋势检验均具有统计学意义(X~2值分别为115.4和239.8,P值均<0.001).结论妊高征增加早产和低出生体重的发生风险.     

Hospitalizations in adolescence and early adulthood among Swedish men and women born preterm or small for gestational age

BACKGROUND: Preterm birth and reduced intrauterine growth appear to be related to morbidity in childhood and later adulthood. We studied whether the risk of all-cause hospitalization in adolescence and early adulthood differed between individuals who were born preterm or small for gestational age (SGA) compared with those born at term and appropriate for gestational age. METHODS: Using Swedish registries, we followed 304,275 men and women born in 1973-1975 for any hospitalizations occurring in 1987-1996. Preterm birth was defined as <37 weeks of gestation and SGA as babies smaller than 2 standard deviations below the mean weight for gestational length, according to Swedish standards. We created 3 mutually exclusive categories: "preterm" (<37 weeks and not SGA), "SGA" (SGA and not preterm), and "both preterm and SGA." The comparison group was all term births not SGA. Childhood socioeconomic characteristics were accounted for in the analyses. RESULTS: The overall risk of hospitalization was higher for men and women born SGA (adjusted odds ratio = 1.16; 95% confidence interval = 1.12-1.21), for those born preterm (1.06; 1.02-1.10), and for those born both preterm and SGA (1.42; 1.26-1.59). In addition to higher risks for previously reported adverse health outcomes, such as neurodevelopment sequelae and congenital anomalies, men and women born SGA or preterm were more likely to be hospitalized due to unspecified symptoms. SGA also appeared to be associated with genitourinary diseases and drug use. CONCLUSIONS: Men and women born SGA or preterm were at higher risk for hospitalization during adolescence and early adulthood, with men and women born SGA more at risk than those born preterm.     

Moderate alcohol drinking and risk of preterm birth

OBJECTIVE: We have analysed the association between alcohol drinking before and during the three trimesters of pregnancy and risk of preterm birth of babies with normal weight for gestational age or with low weight for gestational age (SGA). DESIGN: Case-control study. SETTING: General and university hospitals in Italy. SUBJECTS: Cases were 502 women who delivered preterm births <37 weeks gestation. The controls included 1966 women who gave birth at term (>/=37 weeks of gestation) to healthy infants of normal weight (ie between 10th and 90th centile according to the Italian standard) on randomly selected days at the hospitals where cases had been identified. INTERVENTIONS: Interview. RESULTS: No increased risk of preterm birth was observed in women drinking one or two drinks/die in pregnancy, but three or more drinks/die increased the risk (multivariate odds ratios (OR) 2.0 for >/=3 drinks during the first trimester, 1.8 during the second and 1.9 during the third). When the analysis was conducted separately for preterm births with normal weight or SGA, the increased risk was observed in preterm SGA only (multivariate OR for >/=3 drinks/die during the first trimester=3.6, 95% confidence interval (CI) 1.3-11.1); the estimated multivariate OR for >/=3 drinks/die during the first trimester of preterm babies with normal weight for gestational age was only slightly above unity and not statistically significant (multivariate OR 1.4, 95% CI 0.5-3.7). CONCLUSIONS: The study shows an increased risk in mothers who drink >/=3 die units alcohol in pregnancy of preterm births.     

小于胎龄儿产科危险因素的病例对照研究

目的探讨产科因素及孕母文化程度与小于胎龄儿（SGA）之间的关系。方法采用病例对照方法，选取于2000年1月至2004年10月在第三医院出生的单胎活产SGA，全部病例共834例（男443例，女391例）作为病例组。以胎儿性别及出生胎龄进行频数匹配，按1：3的比例，采用完全随机抽样方法选取性别及胎龄别出生体重在10％～90％分位的适于胎龄儿2502名（男1329名，女1173名）为对照组，比较了病例组及对照组新生儿母亲年龄、文化程度及主要产科危险因素的比例。结果多因素logistic回归分析显示，SGA病例组母亲妊娠合并妊娠高血压综合征（妊高征）、羊水过少、有既往异常妊娠史和病毒性肝炎与对照组比较，OR值（95％Cj）分别为4．00（2．81～5．71）、2．95（2．27～3-83）、5．95（3．05～10．64）和0．50（0．30～0．84）；SGA母亲为初中及以下文化程度者与大专或以上文化程度者比较OR=3．46（95％CI：2．75～4．24）。其他因素与SGA无统计学意义的关联。结论孕母文化程度低、孕期合并妊高征、羊水过少、不良妊娠史可显著增加SGA发生的危险性。     

Social class inequalities in perinatal outcomes: Scotland 1980-2000

OBJECTIVE: To examine social class inequalities in adverse perinatal events in Scotland between 1980 and 2000 and how these were influenced by other maternal risk factors. DESIGN: Population based study using routine maternity discharge data. SETTING: Scotland. PARTICIPANTS: All women who gave birth to a live singleton baby in Scottish hospitals between 1980 and 2000 (n=1,282,172). MAIN OUTCOME MEASURES: Low birth weight (LBW), preterm birth, and small for gestational age (SGA). RESULTS: The distribution of social class changed over time, with the proportion of mothers with undetermined social class increasing from 3.9% in 1980-84 to 14.8% in 1995-2000. The relative index of inequality (RII) decreased during the 1980s for all outcomes. The RII then increased between the early and late 1990s (LBW from 2.09 (95%CI 1.97, 2.22) to 2.43 (2.29, 2.58), preterm from 1.52 (1.44, 1.61) to 1.75 (1.65, 1.86), and SGA from 2.28 (2.14, 2.42) to 2.49 (2.34, 2.66) respectively). Inequalities were greatest in married mothers, mothers aged over 35, mothers taller than 164 cm, and mothers with a parity of one or more. Inequalities were also greater by the end of the 1990s than at the start of the 1980s for women of parity one or more and for mothers who were not married. CONCLUSION: Despite decreasing during the 1980s, inequalities in adverse perinatal outcomes increased during the 1990s in all strata defined by maternal characteristics.