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Updated: Jun 16, 2025

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Interpregnancy interval and adverse perinatal outcomes: A within-individual comparative method.

Maria Sevoyan1, Marco Geraci1,2, Edward A Frongillo3

  • 1Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia South Carolina USA.

Health Science Reports
|August 21, 2024
PubMed
Summary

Short interpregnancy intervals (IPIs) did not increase risks for preterm birth, small-for-gestational-age, low birthweight, or NICU admission. However, longer IPIs of 24 months or more were linked to higher odds of low birthweight.

Keywords:
adverse perinatal outcomesbirth spacinginterpregnancy intervalsibling comparisonwithin‐individual comparisonwithin‐woman comparison

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Area of Science:

  • Reproductive Epidemiology
  • Maternal-Fetal Medicine
  • Perinatal Health

Background:

  • Previous studies on interpregnancy interval (IPI) and perinatal outcomes used between-individual methods, potentially confounded by unmeasured maternal factors.
  • This study employed within-individual analyses to provide a more robust examination of the IPI-perinatal outcome association.

Purpose of the Study:

  • To investigate the association between interpregnancy interval (IPI) and adverse perinatal outcomes using within-individual comparative analyses.
  • To mitigate confounding from unmeasured, time-invariant maternal characteristics.

Main Methods:

  • Utilized data from 10,647 individuals with at least three liveborn singleton pregnancies from the NICHD Consecutive Pregnancies Study.
  • Employed conditional logistic regression, matching two IPIs per individual and adjusting for within-individual factors.
  • Examined outcomes including preterm birth (PTB), small-for-gestational-age (SGA), low birthweight (LBW), and NICU admission.

Main Results:

  • No significant increase in odds for PTB, SGA, LBW, or NICU admission was observed for IPIs <6 months compared to the 18-23 month reference interval.
  • IPIs of 6-11 months and 12-18 months also showed no clear association with increased odds of adverse outcomes.
  • An interpregnancy interval of ≥24 months was associated with increased odds of delivering a low birthweight infant.

Conclusions:

  • Within-individual analyses did not support an association between short interpregnancy intervals (<6 months) and increased odds of adverse perinatal outcomes.
  • Longer interpregnancy intervals (≥24 months) were associated with a higher likelihood of low birthweight.
  • The findings highlight the importance of considering the directionality of IPI effects on specific perinatal outcomes.