Modulators of length of gestation: A study in Greece

In order to ascertain correlates of gestational age and predictorsof prematurity, all the mothers delivered in 1993 at the maternityclinic of the First University Department of Obstetrics andGynaecology and at one division of a private maternity hospitalin Athens, Greece, were interviewed. From a total of 3,770 deliveries,those involving multiple pregnancies or Caesarean deliverieswere excluded, as were pregnancies with an apparent durationof less than 150 or more than 300 days. The analysis was eventuallybased on 2,538 singleton deliveries. The duration of gestationwas modelled as an outcome variable through multiple regression.The following factors were found to be significantly (p<0.05)related to the duration of gestation: maternal education, +0.8day per 3 schooling years; family integrity, single comparedto currently married mother, –3.7 days; parity, muttiparous(4+ births) compared to primiparae, +2.8 days; age at menarche,+1.8 days per 2 years; maternal age, +3.9 days for younger than20 years and –1.7 days for older than 30 years in comparisonto women 20–29 years old; maternal weight before pregnancy,+0.4 day per 5 kg; coffee drinking, +0.7 day per cup per day;tobacco smoking, –1.8 days per 0.5 pack per day. Bleedingduring any trimester of pregnancy and maternal diabetes weresignificantly associated with shorter duration of gestationby 6.7 and 8.2 days respectively. The constellation of riskfactors for a pre-term delivery in Greece appears similar tothat in other populations. However, a positive association betweencoffee drinking and duration of pregnancy has not always beendemonstrated in other studies and the longer duration of pregnancyamong very young women represents an unusual finding. At therange of variation under investigation the individual factorsare not powerful predictors but their combination could identifywomen at high risk for prematurity.