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144: Partner- and partnership-related risk factors for preterm birth among low-income women in Lima, Peru

      Objective

      A woman's partner and the characteristics of their partnership can play an important role in the health of her pregnancy, yet there has been little previous research addressing the associations between partner factors and birth outcomes. We aimed to test the hypothesis that risk factors related specifically to a woman's partner or the partnership itself may increase the risk of preterm birth.

      Study Design

      Between 2003 and 2005, a total of 580 preterm cases (20-36 weeks gestational age at delivery) and 633 term controls (37 weeks) were enrolled from women delivering at an obstetric hospital in Lima, Peru. Each woman completed a structured interview and provided biological specimens within 48 hours after delivery. Multivariate logistic regression was used to assess associations between partner and partnership characteristics and preterm birth.

      Results

      After adjustment for behavioral, demographic, and obstetric risk factors, ever having had a partner with a history of drug use (OR=1.91, 95% CI 1.22-2.99), ever having had anal sex (OR=1.40, 95% CI 1.07-1.84), having a current partner with a history of visiting prostitutes (OR=1.69, 95% CI 1.22-2.33), and perceiving one's current partner as a “womanizer” (OR=1.34, 95% CI 1.02-1.77) were significantly associated with an elevated risk of PTB when tested in separate models. These four factors were then used to create a composite partnership risk score, which showed an increasing dose-response relationship with PTB risk (OR=1.31 for each additional partner factor, 95% CI 1.16-1.49, p=0.001). Other partner factors including short duration of current relationship, large age difference, and partner prison history were not associated with PTB.

      Conclusion

      Our results highlight the importance of considering a broader set of risk factors for PTB, specifically those related to a woman's partner and partnership characteristics. Partner factors may influence risk of PTB through exposure to sexually transmitted infections and/or maternal stress, although further research is needed to clarify the specific mechanisms.