Impact of low birth weight on subsequent fertility: population based register study

Summary Adverse birth outcomes may influence a family’s wish for additional children. We investigated the influence of low birthweight in live births on subsequent fertility, and estimated secular trends of such an effect in a population-based cohort study of births arranged in consecutive sibship records in the Medical Birth Registry of Norway. We included births of order one to seven to all 587 785 mothers in Norway who had a first singleton birth in 1967–91. Associations between birthweight in 1 158 072 surviving index births of order one to six, 1967–91, and subsequent fertility (probability of another birth), 1967–97, were estimated as fertility ratios in Cox regression analysis. Giving birth to a live infant weighing 3000 g had a negative effect on subsequent fertility, increasingly strong for decreasing birthweight. Low birthweight (2500 g) was associated with a fertility ratio of 0.88 [95% confidence interval 0.87, 0.89]. This negative impact was stronger if the mother had also given birth to surviving children of low birthweight previously, particularly if combined with caesarean section in the most recent birth. The negative fertility effect of low birthweight grew slightly stronger between 1967 and 1980, according to year of first birth. This trend paralleled reduced [...]