No abstract

No abstract

1 we wonder whether a short interpregnancy interval might be confounded by factors that were not considered in the analysis. Although all the women studied were drawn from military families with access to high-quality health care, no information was provided about the proportion of mothers who worked and what types of occupations they had. Since it has previously been shown that physical exertion associated with employment in the Army may increase the risk of preterm delivery, 2 might a racial difference in employment patterns account to some extent for the increased risk of preterm birth among the black women in the sample?The large racial difference in the prevalence of low birth weight or preterm delivery among women with interpregnancy intervals of 3 to 5.9 months also deserves comment. It is puzzling to find that this interpregnancy interval has such a disparate effect among black women as compared with white women, when no marked racial difference is apparent at shorter or longer intervals. Nonetheless, the presence of a racial difference associated with even one interpregnancy interval suggests that short intervals themselves cannot wholly explain the racial disparity in pregnancy outcomes.Also noteworthy is the fact that interpregnancy intervals of less than nine months are associated with poor outcomes among black women, whereas only the shortest intervals (less than three months) are disadvantageous for white women.The authors report in addition that the adverse effect of a short interpregnancy interval was strongest when the preceding pregnancy resulted in a low-birth-weight or preterm infant. These findings are interesting and merit additional discussion. Instructions for Letters to the EditorLetters to the Editor are considered for publication (subject to editing and abridgment) provided they do not contain material that has been submitted or published elsewhere. Please note the following:• Your letter must be typewritten and triple-spaced. • Its text, not including references, must not exceed 400 words (please include a word count). • It must have no more than five references and one figure or table.• It should not be signed by more than three authors. • Letters referring to a recent Journal article must be received within four weeks of its publication. • Please include your full address, telephone number, and fax number (if you have one). Our fax numbers: 617-739-9864 and 617-734-4457Our Internet address: letters@edit.nejm.orgWe cannot acknowledge receipt of your letter, but we will notify you when we have made a decision about publication. We are unable to provide prepublication proofs. Please enclose a stamped, self-addressed envelope if you want unpublished material returned to you.Financial associations or other possible conflicts of interest must be disclosed. Submission of a letter constitutes permission for the Massachusetts Medical Society, its licensees, and its assignees to use it in the Journal 's various editions (print, data base, and optical disk) and in anthologies, revisions, and an...

No abstract