Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study

Abstract Introduction Preterm birth is subject to seasonal periodicity, dependent on geographical, meteorological, and environmental factors. This study aims to assess whether preterm birth in the Netherlands is subject to seasonal periodicity. Material and Methods We performed a population‐based co...

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Main Authors: Annabelle L. vanGils, Anita C. Ravelli, Brenda M. Kazemier, Eva Pajkrt, Martijn A. Oudijk
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Acta Obstetricia et Gynecologica Scandinavica
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Online Access:https://doi.org/10.1111/aogs.15134
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author Annabelle L. vanGils
Anita C. Ravelli
Brenda M. Kazemier
Eva Pajkrt
Martijn A. Oudijk
author_facet Annabelle L. vanGils
Anita C. Ravelli
Brenda M. Kazemier
Eva Pajkrt
Martijn A. Oudijk
author_sort Annabelle L. vanGils
collection DOAJ
description Abstract Introduction Preterm birth is subject to seasonal periodicity, dependent on geographical, meteorological, and environmental factors. This study aims to assess whether preterm birth in the Netherlands is subject to seasonal periodicity. Material and Methods We performed a population‐based cohort including singleton births between January 1, 2010 and December 31, 2019 between 24 + 0 and 42 + 6 weeks of gestation in the Netherlands. The primary outcome was the incidence of preterm birth <37 weeks. Secondary outcomes were total, spontaneous, and iatrogenic preterm birth <28, <32, and <37 weeks of gestation. Preterm birth incidence was calculated per conception month and as a proportion of fetuses‐at‐risk, taking into account the number of ongoing pregnancies at risk for preterm birth. The incidence of preterm birth <37 weeks per conception month and out of fetuses‐at‐risk was plotted for the 10‐year study period. Incidences were reported as rates, and seasonality was tested with logistic regression and autocorrelation function with a 12‐month lag. Results In total, 1 598 554 births were included in the 10‐year study period. The average monthly birth count varied from 12 006 (February) to 14 293 (September). The average monthly preterm birth count varied from 610 (February) to 728 (July). Over the total study period, the incidence of preterm birth <37 weeks was 5.16%. Pregnancies conceived in April and May had the highest incidences of preterm birth <37 weeks (5.58% and 5.38%, respectively). Out of fetuses‐at‐risk, preterm birth incidences were highest in October, December, and January (between 1.38% and 1.42%) and lowest in February (1.22%) and April (1.22%). The ten‐year incidence of preterm birth <37 weeks revealed a consistent seasonal pattern, with annually recurrent peaks in preterm birth incidence each year (p < 0.001). Conclusions In the Netherlands, the incidence of preterm birth in singletons is subject to seasonal periodicity. Conception in April and May is associated with the highest risk of preterm birth. Fetuses are at the highest risk for preterm birth from October to January and at the lowest risk in February and April.
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spelling doaj-art-4bfb7544e4df4813bfafba6ed656e4c22025-08-20T02:09:24ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-07-0110471286129410.1111/aogs.15134Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort studyAnnabelle L. vanGils0Anita C. Ravelli1Brenda M. Kazemier2Eva Pajkrt3Martijn A. Oudijk4Amsterdam UMC, Department of Obstetrics and Gynecology University of Amsterdam Amsterdam The NetherlandsAmsterdam UMC, Department of Obstetrics and Gynecology University of Amsterdam Amsterdam The NetherlandsAmsterdam UMC, Department of Obstetrics and Gynecology University of Amsterdam Amsterdam The NetherlandsAmsterdam UMC, Department of Obstetrics and Gynecology University of Amsterdam Amsterdam The NetherlandsAmsterdam Reproduction and Development Research Institute Amsterdam The NetherlandsAbstract Introduction Preterm birth is subject to seasonal periodicity, dependent on geographical, meteorological, and environmental factors. This study aims to assess whether preterm birth in the Netherlands is subject to seasonal periodicity. Material and Methods We performed a population‐based cohort including singleton births between January 1, 2010 and December 31, 2019 between 24 + 0 and 42 + 6 weeks of gestation in the Netherlands. The primary outcome was the incidence of preterm birth <37 weeks. Secondary outcomes were total, spontaneous, and iatrogenic preterm birth <28, <32, and <37 weeks of gestation. Preterm birth incidence was calculated per conception month and as a proportion of fetuses‐at‐risk, taking into account the number of ongoing pregnancies at risk for preterm birth. The incidence of preterm birth <37 weeks per conception month and out of fetuses‐at‐risk was plotted for the 10‐year study period. Incidences were reported as rates, and seasonality was tested with logistic regression and autocorrelation function with a 12‐month lag. Results In total, 1 598 554 births were included in the 10‐year study period. The average monthly birth count varied from 12 006 (February) to 14 293 (September). The average monthly preterm birth count varied from 610 (February) to 728 (July). Over the total study period, the incidence of preterm birth <37 weeks was 5.16%. Pregnancies conceived in April and May had the highest incidences of preterm birth <37 weeks (5.58% and 5.38%, respectively). Out of fetuses‐at‐risk, preterm birth incidences were highest in October, December, and January (between 1.38% and 1.42%) and lowest in February (1.22%) and April (1.22%). The ten‐year incidence of preterm birth <37 weeks revealed a consistent seasonal pattern, with annually recurrent peaks in preterm birth incidence each year (p < 0.001). Conclusions In the Netherlands, the incidence of preterm birth in singletons is subject to seasonal periodicity. Conception in April and May is associated with the highest risk of preterm birth. Fetuses are at the highest risk for preterm birth from October to January and at the lowest risk in February and April.https://doi.org/10.1111/aogs.15134fetus‐at‐riskpreterm birthpreterm laborseasonal patternseasonal trendseasonality
spellingShingle Annabelle L. vanGils
Anita C. Ravelli
Brenda M. Kazemier
Eva Pajkrt
Martijn A. Oudijk
Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study
Acta Obstetricia et Gynecologica Scandinavica
fetus‐at‐risk
preterm birth
preterm labor
seasonal pattern
seasonal trend
seasonality
title Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study
title_full Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study
title_fullStr Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study
title_full_unstemmed Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study
title_short Seasonal patterns of preterm birth in the Netherlands: A population‐based cohort study
title_sort seasonal patterns of preterm birth in the netherlands a population based cohort study
topic fetus‐at‐risk
preterm birth
preterm labor
seasonal pattern
seasonal trend
seasonality
url https://doi.org/10.1111/aogs.15134
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AT anitacravelli seasonalpatternsofpretermbirthinthenetherlandsapopulationbasedcohortstudy
AT brendamkazemier seasonalpatternsofpretermbirthinthenetherlandsapopulationbasedcohortstudy
AT evapajkrt seasonalpatternsofpretermbirthinthenetherlandsapopulationbasedcohortstudy
AT martijnaoudijk seasonalpatternsofpretermbirthinthenetherlandsapopulationbasedcohortstudy