Objective: Interpregnancy interval (IPI) influences numerous adverse perinatal outcomes. IPI's impact on birth defects is unclear. Study Design:We conducted a population-based case-control study, using 1998 to 2008 administrative data from Washington State. A total of 10 772 cases, women whose second of two births resulted in an infant with a birth defect, were compared with 32 310 controls, women whose second of two births did not result in an infant with a birth defect.Result: Compared with mothers with an IPI between 18 to 23 months, those with an IPI <6 months or X60 months had elevated risks of delivering an infant with a birth defect (odds ratio ¼ 1.15, 95% confidence interval: 1.03 to 1.28, and odds ratio ¼ 1.15, 95% confidence interval: 1.04 to 1.26, respectively). Conclusion:We observed a J-shaped relationship between IPI and risk of having an infant with a birth defect. As this is one of the first studies to evaluate this association, confirmatory studies are needed.

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Introduction This issue of the feature column reports on developments in Peru on the use of information and communication technologies to improve public health. The authors describe how cell phones and hand‐held devices are being deployed to monitor diseases. Recent concerns about the spread of swine flu highlight the importance of robust public health systems in developing countries.1 Jeannete Murphy Reference