Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: a large multi‐country study

Abstract

ObjectiveTo determine the relationship of interpregnancy interval with maternal and offspring outcomes.DesignRetrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay.SettingLatin America, 1990–2009.PopulationA cohort of 894 476 women delivering singleton infants.MethodsDuring 1990–2009 the Perinatal Information System database of the Latin American Centre for Perinatology identified 894 476 women with defined interpregnancy intervals: i.e. the time elapsed between the date of the previous delivery and the first day of the last normal menstrual period for the index pregnancy. Using the interval 12–23 months as the reference category, multiple logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) of the association between various interval lengths and maternal and offspring outcomes.Main outcome measuresMaternal death, pre‐eclampsia, eclampsia, puerperal infection, fetal death, neonatal death, preterm birth, and low birthweight.ResultsIn the reference interval there was 0.05% maternal death, 1.00% postpartum haemorrhage, 2.80% pre‐eclampsia, 0.15% eclampsia, 0.28% puerperal infection, 3.45% fetal death, 0.68% neonatal death, 12.33% preterm birth, and 9.73% low birthweight. Longer intervals had increased odds of pre‐eclampsia (>72 months), fetal death (>108–119 months), and low birthweight (96–107 months). Short intervals of <12 months had increased odds of pre‐eclampsia (aOR 0.80; 95% CI 0.76–0.85), neonatal death (aOR 1.18; 95% CI 1.08–1.28), and preterm birth (aOR 1.16; 95% CI 1.11–1.21). Statistically, the interval had no relationship with maternal death, eclampsia, and puerperal infection.ConclusionsA short interpregnancy interval of <12 months is associated with pre‐eclampsia, neonatal mortality, and preterm birth, but not with other maternal or offspring outcomes. Longer intervals of >72 months are associated with pre‐eclampsia, fetal death, and low birthweight, but not with other maternal or offspring outcomes.Tweetable abstractA short interpregnancy interval of <12 months is associated with neonatal mortality and preterm birth.

A first look at the effects of long inter‐pregnancy interval and advanced maternal age on perinatal outcomes: A retrospective cohort study

“…The preexisting medical conditions rate in this study (28.8%) was higher than Timofeev's result (0.1‐10.3%) . This might be because we have included a large number of possible co‐morbidities, whereas other studies included only pregestational diabetes and chronic hypertension …”

“…However, studies have shown that usage rates for these substances among Chinese women are very low . Data were also not available on the details of the first pregnancy, type of contraception used, or in vitro fertilization . Also, data were collected from three provincial hospitals, thus results may not be generalizable to China as a whole.…”

“…studies have compared short IPI (≤6 months) with typical IPI (12-23 months) and have found that births following short IPI had higher rates of adverse perinatal outcomes. 1,3,6,8,10 However, studies of the impact of long IPIs have been sparse. Only a few articles included subgroups of IPIs longer than 60 months.…”

Heterogeneous Effects of Birth Spacing on Neonatal Mortality Risks in Bangladesh

“…2014; Mignini et al. 2016). A recent study using historical data even showed that as the overall level of child mortality declined, the negative effect of preceding inter‐birth interval length on mortality approached zero (Molitoris 2017).…”

Corrigendum

“…In the following article, there were errors in the abstract and results section on pages 730 and 732 respectively.…”