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Published on: November 20, 2015
Inter-pregnancy interval and long-term neurological morbidity of the offspring
David Elhakham1, Tamar Wainstock2, Eyal Sheiner3
1Faculty of Health Sciences, Joyce & Irving Goldman Medical School at Ben Gurion University of the Negev, Beer-Sheva, Israel.
Insights
A long interpregnancy interval (IPI) is linked to a higher risk of neurological issues in children. This study found that a long IPI independently increases the likelihood of long-term neurological morbidity in offspring.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Neurology
- Reproductive Health
Background:
- Interpregnancy interval (IPI) is the time between pregnancies.
- Previous studies suggest associations between IPI and various maternal and infant outcomes.
- The impact of IPI on long-term neurological outcomes in offspring requires further investigation.
Purpose of the Study:
- To evaluate the effect of interpregnancy interval (IPI) on the long-term neurological morbidity of offspring.
- To determine if different IPI durations pose varying risks for neurological development.
Main Methods:
- Retrospective cohort study of 144,397 singleton infants born to multiparous mothers (1991-2014).
- Infants were categorized into three IPI groups: short (<6 months), intermediate (6-60 months), and long (>60 months).
- Long-term neurological morbidity was assessed up to 18 years of age using Kaplan-Meier curves and Cox regression analysis.
Main Results:
- Offspring born after a long IPI exhibited higher rates of neurological morbidity (3.62%) compared to short (3.18%) and intermediate (3.19%) IPI groups (p=0.041).
- The cumulative incidence of long-term neurological morbidity was significantly higher in the long IPI group (log-rank test p<0.001).
- A long IPI was identified as an independent risk factor for offspring neurological morbidity (aHR 1.2; 95% CI 1.1-1.4; p<0.001).
Conclusions:
- A long interpregnancy interval is independently associated with an increased risk of long-term neurological morbidity in offspring.
- These findings highlight the importance of considering IPI in reproductive health counseling and prenatal care.
- Optimizing IPI may contribute to improved long-term neurological health outcomes for children.
Purpose:
The purpose of our study was to evaluate the effect of IPI on long-term neurological morbidity of the offspring.
Methods:
In this retrospective cohort study, 144,397 singleton infants born to multiparous mothers, between the years 1991 and 2014 in a tertiary medical center, were evaluated for different perinatal outcomes and were followed until 18 years of age for long-term neurological morbidity according to three IPI groups: Short IPI (< 6 months), long IPI (> 60 months) and intermediate IPI (6-60 months). We used a Kaplan-Meier survival curve to compare cumulative incidence of long-term neurological morbidity, and a Cox regression analysis to control for confounders such as gestational age, birth weight and maternal age.
Results:
Offspring born to mothers with long IPI had higher rates of neurological morbidity (3.62% among offspring born after long IPI vs. 3.18% and 3.19% among offspring born after short and intermediate IPI, respectively, p = 0.041). The cumulative incidence of long-term neurological morbidity was significantly higher in the long IPI group (Kaplan-Meier log-rank test p < 0.001). Being born after a long IPI was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted hazard ratio 1.2; 95% confidence interval 1.1-1.4; p < 0.001).
Conclusion:
Long IPI is independently associated with an increased risk of long-term neurological morbidity of the offspring.
