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Maternal Age Differences in Interpregnancy Interval and Preterm Birth Associations Accounting for Multiple
Julie M Petersen1,2,3, Mahsa M Yazdy1, Anne Marie Darling1
1Division for Family Health Data and Analytics, Massachusetts Department of Public Health, Boston, Massachusetts, USA.
Paediatric and Perinatal Epidemiology
|April 30, 2025
Summary
Short interpregnancy intervals (IPI) increase preterm birth (PTB) risk, especially for younger mothers. Older mothers may have lower PTB risk with shorter IPI, suggesting age-tailored guidance is needed.
Area of Science:
- Reproductive Health
- Maternal-Fetal Medicine
- Epidemiology
Background:
- Current recommendations advise a 6-month interpregnancy interval (IPI) before the next pregnancy, with 18 months considered optimal.
- These guidelines are not personalized for maternal age or other characteristics.
- Understanding how maternal age affects the relationship between IPI and preterm birth (PTB) is crucial for refining recommendations.
Purpose of the Study:
- To investigate whether maternal age modifies the association between interpregnancy intervals (IPI) and preterm birth (PTB).
Main Methods:
- A retrospective US cohort study analyzed data from 1997-2011.
- Interpregnancy intervals (IPI) were categorized (<6, 6-11, 12-17, 18-23, 24-59, ≥60 months).
- Modified Poisson regression was used to estimate risk ratios (RR) for PTB, stratified by maternal age (<25, 25-29, ≥30 years), with bias analyses conducted.
Main Results:
- Preterm birth (PTB) risk was highest with IPIs <6 months across all maternal age groups.
- The association between short IPI and PTB was strongest in the 25-29 year age group.
- For mothers aged ≥30 years, PTB risk was lowest with IPIs of 6-17 months.
Conclusions:
- While estimates were imprecise, findings suggest that interpregnancy interval (IPI) associations with preterm birth (PTB) may be weaker in older individuals.
- Older mothers with shorter IPIs might experience lower PTB risk compared to those adhering to current recommendations.
- Further research is necessary to confirm these patterns and inform age-specific guidelines for interpregnancy spacing.
Keywords:
birth intervalsepidemiologic biasepidemiologic confounding factorspreterm birthquantitative bias analysisselection biasMore Related Videos
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