—We thank Berkowitz et al for their comments. Women who delay childbearing in both countries are well-educated, married, healthy, smoke less, and attend prenatal care early. In our study, 49% of women aged 30 years and older had a college education or more, which is identical to that quoted for the United States (written communication, S. J. Ventura, National Center for Health Statistics, Hyattsville, Md, October 25,1989). Cigarette smoking among women who delay childbearing was 24% in Sweden and 26% in the United States among white females aged 13 to 15 years, and 16.4% in those with 16 or more years of education. By contrast, in the Mount Sinai study, 94% of the women had attended college—a rate about twice as high as that in the United States and Sweden. Smoking was reported for 3.6%, which is only a fraction of the rate reported for the United States
Berendes HW, Forman MR, Cnattingius S. Does Delayed Childbearing Increase Risk?-Reply. JAMA. 1993;269(6):746–747. doi:10.1001/jama.1993.03500060045023
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