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Interpregnancy interval and the risk of premature infants
E Fuentes-Afflick1, N A Hessol
1Department of Pediatrics, University of California, San Francisco 94110, USA.
Insights
Short interpregnancy intervals (<18 months) and long intervals (>59 months) increase the risk of premature birth. The optimal interpregnancy interval for reducing prematurity risk is 18-59 months.
Area of Science:
- Reproductive Health
- Perinatal Epidemiology
- Maternal-Fetal Medicine
Background:
- Interpregnancy intervals (IPIs) are linked to low birth weight.
- The association between IPIs and infant prematurity remains unclear.
Purpose of the Study:
- To investigate the relationship between interpregnancy intervals and the risk of premature birth.
- To quantify the risk of prematurity associated with different interpregnancy intervals.
Main Methods:
- Analysis of 289,842 singleton births to parous Hispanic and non-Hispanic white women in the US.
- Defined IPI as months between prior live birth and current conception.
- Used multivariate logistic regression to assess IPI risk for very premature, moderately premature, and term births.
Main Results:
- 37% of women had IPIs <18 months; 45.5% had 18-59 months; 17.6% had >59 months.
- IPIs <18 months increased risk of very and moderately premature infants by 14-47% compared to 18-59 months.
- IPIs >59 months increased risk of very and moderately premature infants by 12-45% compared to 18-59 months.
Conclusions:
- The lowest risk of premature birth was observed with interpregnancy intervals of 18-59 months.
- Further research is needed to elucidate the mechanisms linking IPI to pregnancy outcomes.
Objective:
Interpregnancy intervals are associated with the risk of low birth weight (LBW) infants, but the association between interpregnancy interval and prematurity is unknown. Our objective was to determine whether interpregnancy intervals were associated with the risk of premature infants and to define the degree of risk according to interpregnancy interval.
Methods:
We analyzed 289,842 singleton infants born to parous Mexican-origin Hispanic and non-Hispanic white women in the United States who resided in the same county and delivered between January 1, 1991 and September 30, 1991. Interpregnancy interval was defined as the number of months between the previous live birth and conception of the index pregnancy. Multivariate logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for the risk of interpregnancy interval on very premature (23-32 weeks), moderately premature (33-37 weeks), and term gestation (38-42 weeks).
Results:
Nearly 37% of women had interpregnancy intervals less than 18 months, 45.5% of women had intervals of 18-59 months, and 17.6% of women had intervals over 59 months. After adjusting for confounding variables, women with intervals less than 18 months were 14-47% more likely to have very premature and moderately premature infants than women with intervals of 18-59 months. Women with intervals over 59 months were 12-45% more likely to have very premature and moderately premature infants than women with intervals of 18-59 months.
Conclusion:
Women with interpregnancy intervals from 18-59 months had the lowest risk of very premature and moderately premature infants. Further study is needed to define the mechanisms through which interpregnancy interval influences pregnancy outcome.