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Short interbirth interval and adverse pregnancy outcomes: a Bayesian network approach.

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Summary

Short interpregnancy intervals (IBI) are linked to low birth weight, particularly in young mothers. The association between short IBI and preterm birth or gastroschisis is indirect, influenced by maternal age and prior abortions.

Keywords:
gastroschisisinterbirth intervallow birth weightmaternal ageprevious abortion

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Area of Science:

  • Reproductive Health
  • Perinatal Epidemiology
  • Obstetrics

Background:

  • Interbirth interval (IBI) is the time between consecutive births and is associated with perinatal outcomes.
  • Understanding the impact of short IBI on adverse perinatal events is crucial for maternal and child health.
  • Previous studies suggest a link between short IBI and negative pregnancy outcomes.

Purpose of the Study:

  • To investigate adverse perinatal events, including preterm birth (PTB), low birth weight (LBW), and birth defects, following short interpregnancy intervals (IBI).
  • To analyze these outcomes in a large South American population, considering various confounding factors.
  • To elucidate the complex relationships between IBI, maternal characteristics, and perinatal outcomes using advanced statistical methods.

Main Methods:

  • An observational, retrospective, hospital-based study was conducted, including live- and stillbirths (malformed and nonmalformed).
  • Logistic regression and Bayesian networks were employed to analyze the risk of short IBI and adverse outcomes, adjusting for confounders like maternal age and previous abortion.
  • Key outcomes assessed included PTB, LBW, and specific birth defects such as gastroschisis.

Main Results:

  • The rate of short IBI was 2%-3%. Young maternal age (≤19 years) was a significant risk factor for short IBI, while older mothers (≥30 years) had a lower risk, mediated by previous abortion.
  • Short IBI was a significant risk factor for LBW after adjusting for confounders, but not for PTB.
  • An unadjusted association between short IBI and gastroschisis was observed, but this disappeared after adjusting for confounders; young maternal age and previous abortion were directly linked to gastroschisis.

Conclusions:

  • Short interpregnancy intervals are directly associated with adverse perinatal outcomes, primarily low birth weight, especially in younger mothers.
  • The relationship between short IBI and preterm birth or gastroschisis is indirect, mediated by factors such as young maternal age and a history of abortion.
  • Maternal age and prior abortion history are critical factors influencing both short IBI and specific birth defects, highlighting the need for targeted interventions.