Effects of short inter-pregnancy interval on maternal and perinatal outcomes: A cohort study of pregnant women in a low-income country

Onwuka, CI; Ugwu, EO; Obi, S N; Onwuka, Chidinma Ifechi; Dim, Cyril Chukwudi; Eleje, George Uchenna; Ezugwu, Euzebus Chinonye; Agu, Polycarp Uchenna; Nwagha, UI; Ozumba, Benjamin C.

doi:10.4103/njcp.njcp_423_19

Cited by 12 publications

(10 citation statements)

References 2 publications

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“…Studies also indicate that although women’s iron levels typically recover 4–6 weeks after delivery, women from low socioeconomic backgrounds require substantially longer periods to replenish their stores 15. This deficiency is further exacerbated due to HRFB, such as smaller than recommended interpregnancy intervals and longer duration of breast feeding 29. This is worsened when adolescents reach pregnancy with low nutritional reserves 27.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anaemia among married women with recent birth history and high-risk fertility behaviour: secondary data analysis of the National Family Health Survey-India (2019–21)

Das,

Verma,

Barman

et al. 2024

BMJ Open

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ObjectivesTo describe the prevalence of anaemia among currently married women with high-risk fertility behaviour (HRFB) based on age, parity and birth spacing indicators.DesignCross-sectional study.Settings and participantsFifth round of the National Family Health Survey (NFHS) was conducted in India (2019–2021) and included a nationally representative sample of 724, 115 women in the reproductive age group (15–49). Our analysis focused exclusively on married women who had given birth in the preceding 5 years.Primary and secondary outcome measuresThe prevalence of anaemia with HRFB was the primary outcome, and the likelihood of having anaemia due to HRFB was the secondary outcome.Data and methodsSecondary data analysis of the NFHS-5 (2019–2021) datasets was done using a weighted analysis to determine anaemia prevalence in different HRFB categories. Bivariate analysis was done using the χ2test, and multiple binary logistic regression analyses were done to estimate the odds of having anaemia due to HRFB after adjusting for known confounders. A p value <0.05 was reported as statistically significant.ResultsThe final analysis comprised 145,468 women, of whom 59.1% had anaemia. About 53.1% of women depicted ‘No risk’ fertility behaviour, and 34.6% and 12.3% had single and multiple HRFB. Women with ‘no-risk,’ single and multiple HRFB had anaemia prevalence rates of 58.1%, 59.4% and 63.1%, respectively. Women with ‘Single risk’ had an 18% higher likelihood (1.18; 1.13–1.22) of having anaemia after controlling for confounding variables, compared with the HRFB category with ‘No risk.’ Women with ‘Multiple risks’ showed a 6% higher likelihood (adjusted OR 1.06; 95% CI 1.03 to 1.08).ConclusionsAnaemia remains a prevalent issue in India, and HRFB is observed as a significant contributing factor. This vulnerable group can be targeted through multiple interventions and further our efforts to realise our anaemia-related goals.

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Section: Discussionmentioning

confidence: 99%

Prevalence of anaemia among married women with recent birth history and high-risk fertility behaviour: secondary data analysis of the National Family Health Survey-India (2019–21)

Das,

Verma,

Barman

et al. 2024

BMJ Open

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“…Having an inter-pregnancy interval of <18 months was found to contribute to anemia. A short inter-pregnancy interval is said to hinder the restoration of the depleted maternal resources that are needed for the subsequent pregnancy and pose the risk of anemia, pregnancy-induced hypertension, premature rapture of the membranes, and others [40] Several observational studies have confirmed the association between the short inter-pregnancy interval and anemia. [40][41][42] Moreover, this study found that about 41.7% of pregnant women had a short inter-pregnancy interval.…”

Section: Discussionmentioning

confidence: 99%

“…A short inter-pregnancy interval is said to hinder the restoration of the depleted maternal resources that are needed for the subsequent pregnancy and pose the risk of anemia, pregnancy-induced hypertension, premature rapture of the membranes, and others [40] Several observational studies have confirmed the association between the short inter-pregnancy interval and anemia. [40][41][42] Moreover, this study found that about 41.7% of pregnant women had a short inter-pregnancy interval. This raises concerns about family planning use among women of reproductive age in this setting, owing to the potential effect of a short inter-pregnancy interval on anemia.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anemia and its associated factors among pregnant women in Ilala Municipality - Tanzania: Analytical cross-sectional study

Lema

Seif

2023

Medicine

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Anaemia during pregnancy is still 1 of the leading causes of maternal and neonatal mortality in low and middle-income countries. Initiatives to address this need evidence on trends and their relevant factors, as they vary from 1 area to another. This study determined the prevalence of anemia and its associated factors among pregnant women in Ilala, Tanzania. This community-based, analytical cross-sectional study was conducted in April 2022 involving 367 randomly selected pregnant women. An interviewer-administered questionnaire and a HemoCue analyzer were used for data collection The data was described using descriptive statistics (frequency distributions, percentages, etc) and inferential statistics (Chi-square tests and logistic regression) were used to explore the associations between the study’s outcome and its explanatory variables, with a significance level of P < .05. The mean age of participants was 26.2 (standard deviation = 5.2) years, 58.0% had a secondary education level, and 45.2 were prime-para. About half (57.2%) of all participants had low hemoglobin level, among which, 36.2% had moderate anemia. Having a primary education level (adjusted odds ratio [AOR] = 2.3, confidence interval [CI] = 1.1–4.7), having an inter-pregnancy interval of <18 months (AOR = 2.6, CI = 1.2–5.5), being in the third trimester (AOR = 2.4, CI = 1.2–4.7), not taking Intermittent Prophylaxis Treatment (AOR = 3.7, CI = 1.3–10), not taking iron supplement and folic acid (AOR = 3.7, CI = 1.3–10), and having a moderate appetite(AOR = 1.6, CI = 1.0–2.6) were predictors of anemia. Nutritionally related factors were not consuming on a daily basis dairy food (AOR = 3.7, CI = 1.4–9.3), meat/fish (AOR = 6.6, CI = 3–14), dark green and other vegetables (AOR = 6.6, CI = 3.1–14), fruits (AOR = 4.2, CI = 1.4–12) and having a lower dietary diversity score (AOR = 84, CI = 37–188). Approximately half of pregnant women in Ilala municipality were anemic with 1 third of them having moderate anemia. The associated factors varied from nutritional, obstetric, and socio-demographic factors. The targeted interventions should focus on health promotion campaign to sensitize the population on the dangers of anemia in pregnancy and preventive measures that must be adhered to.

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“…e choice of an 18-month cutoff to define a short IPI in this analysis was based on the indicator used in Healthy People 2020 [13]. While some authorities suggest that IPI less than 18 months was associated with increased risk, it is important to note that even within this 18-month window, the level of risk decreases as interval length increases [13,[24][25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…However, there is paucity of data on the relationship between IPI and the risk of placenta previa and placenta accreta spectrum disorder in low-income settings where there are high aversions for cesarean section [ 8 , 12 , 13 ]. It is worthwhile to note that the majority of previous studies were conducted in the western populations [ 3 , 11 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Placenta Previa and Placenta Accreta Spectrum Disorder Following Previous Cesarean Section between Women with a Short and Normal Interpregnancy Interval

Umeh

Eleje

Onuh

et al. 2022

Obstetrics and Gynecology International

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Objectives. The aim of this study is to determine the effect of interpregnancy interval (IPI) on the incidence of placenta previa and placenta accreta spectrum disorders in women with a previous cesarean section. Methods. A prospective cohort three-center study involving parturients who had previous cesarean section was conducted. Participants were included if pregnancy has lasted up to 34 weeks. Parturients with co-existing uterine fibroids, multiple gestations, premature rupture of membranes, and those with prior postcesarean delivery wound infection were excluded. The eligible women recruited were distributed into two groups, namely, short (<18 months) and normal (18–36 months) IPI. The outcome measures were incidences of placenta previa and placenta accreta spectrum disorder and factors associated with the occurrence of placenta previa. A univariate analysis was performed using the chi-square test or Mann–Whitney U test, wherever appropriate, to examine the significance of the differences in clinical variables. Results. A total of 248 women met the inclusion criteria. The incidence of placenta previa by ultrasound was 8.9% and 4.0% for short and normal IPI (odds ratios = 2.32; 95% confidence intervals = 0.78–6.88; p = 0.13 ), respectively. The incidence of placenta accreta spectrum disorder was 1.6% and 0.8% for short and normal IPI (odds ratios = 2.02; 95% confidence intervals = 0.18–22.13; p = 0.57 ), respectively. The only observed significant difference between the clinical variables and placenta previa is the number of cesarean sections ( p = 0.02 ) in women with short IPI. Conclusion. A short interpregnancy interval does not significantly affect the incidence of placenta previa and placenta accreta spectrum disorder following a cesarean section. There is a need for further study with large numbers to corroborate these findings in low- and middle-income settings.

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Effects of short inter-pregnancy interval on maternal and perinatal outcomes: A cohort study of pregnant women in a low-income country

Cited by 12 publications

References 2 publications

Prevalence of anaemia among married women with recent birth history and high-risk fertility behaviour: secondary data analysis of the National Family Health Survey-India (2019–21)

Prevalence of anaemia among married women with recent birth history and high-risk fertility behaviour: secondary data analysis of the National Family Health Survey-India (2019–21)

Prevalence of anemia and its associated factors among pregnant women in Ilala Municipality - Tanzania: Analytical cross-sectional study

Comparison of Placenta Previa and Placenta Accreta Spectrum Disorder Following Previous Cesarean Section between Women with a Short and Normal Interpregnancy Interval

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