Effect of Interpregnancy Interval on Adverse Perinatal Outcomes in Southern China: A Retrospective Cohort Study, 2000–2015

Zhang, Lifang; Shen, Shi‐Li; He, Jianxing; Chan, Fanfan; Lu, Jinhua; Li, Weidong; Wang, Ping; Lam, Hubert; Mol, Ben Willem J.; Yeung, Shiu Lun Au; Xia, Huimin; Schooling, CM; Qiu, Xiu

doi:10.1111/ppe.12432

Cited by 33 publications

(51 citation statements)

References 35 publications

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“…Other studies have reported a similar rate of short IPI 12. These studies identified an association between short IPI and decreased education level, extremes of age, relationship status, minority race, depression, smoking, increased paternal age, low socioeconomic status, and low income 13–18. Our study found a similar association between short IPI and maternal age, although we found contradictory results with regard to education level, relationship status and cultural background.…”

Section: Discussioncontrasting

confidence: 54%

Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception

Yang

Cheney

Taylor

et al. 2019

BMJ Sex Reprod Health

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BackgroundShort interpregnancy intervals (IPIs) are associated with adverse obstetric outcomes. However, few studies have explored women’s understanding of ideal IPIs or investigated knowledge of the consequences of short IPIs.MethodsWe performed a prospective questionnaire-based study at two hospitals in Sydney, Australia. We recruited women attending antenatal clinics and collected demographic data, actual IPI, ideal IPI, contraceptive use, and education provided on birth-spacing and contraception following a previous live birth. We explored associations between an IPI <12 months and a selection of demographic and health variables.ResultsData were collected from 467 women, of whom 344 were pregnant following a live birth. Overall, 72 (20.9%) women had an IPI <12 months only 7.5% of whom believed this was ideal, and the remaining stating their ideal IPI was over 12 months (52.3%) or they had no ideal IPI (40.3%). IPI <12 months following a live birth was significantly associated with younger age (p=0.043) but not with ethnicity, relationship status, education, religion, parity nor previous mode of delivery. IPI <12 months was associated with non-use of long-acting reversible contraception (LARC) (p<0.001), breastfeeding <12 months (p=0.041) and shorter ideal IPI (p=0.03). Less than half of the women (43.3%, n=149) reported having received advice about IPI and less than half about postnatal contraception (44.2%, n=147).ConclusionsYounger age and non-use of LARC are significantly associated with IPIs <12 months. A minority of women with a short IPI perceived it to be ideal. Prevention of short IPIs could be achieved with improved access to postnatal contraception.

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Section: Discussioncontrasting

confidence: 54%

Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception

Yang

Cheney

Taylor

et al. 2019

BMJ Sex Reprod Health

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“…1,2 Interpregnancy interval (IPI), or the time between the end of one pregnancy and the conception of a subsequent pregnancy, has been linked to the risk of adverse pregnancy outcomes. 3 Specifically, short and long IPIs have been associated with increased risk of pregnancy complications, preterm birth, small-for-gestational-age birth, [4][5][6][7][8][9][10] and perinatal death. 4,[11][12][13][14][15] To reduce the risk of these events, the World Health Organization (WHO) recommends that individuals wait at least 2 years following a live birth and 6 months following a miscarriage or induced termination of pregnancy before conceiving again.…”

Section: Introductionmentioning

confidence: 99%

Interpregnancy interval and risk of perinatal death: a systematic review and meta‐analysis

Regan

Arnaout

Marinovich

et al. 2020

BJOG

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Background Interpregnancy interval (IPI) <6 months is a potentially modifiable risk factor for adverse perinatal health outcomes. Objective This systematic review evaluated the international literature on the risk of perinatal death associated with IPI. Search strategy Two independent reviewers screened titles and abstracts identified in MEDLINE, EMBASE and Scopus from inception to 4 April 2019 (Prospero Registration #CRD42018092792). Selection criteria Studies were included if they provided a description of IPI measurement and perinatal death, including stillbirth and neonatal death. Data collection and analysis A narrative review was performed for all included studies. Random effects meta-analysis was used to compare unadjusted odds of perinatal death associated with IPI <6 months and IPI ≥6 months. Analyses were performed by outcome of the preceding pregnancy and study location. Main results Of the 624 unique articles identified, 26 met the inclusion criteria. The pooled unadjusted odds ratio of perinatal death for IPI <6 months was 1.34 (95% CI 1.17-1.53) following a previous live birth, 0.85 (95% CI 0.73-0.99) following a previous miscarriage and 1.07 (95% CI 0.84-1.36) following a previous stillbirth compared with IPI ≥6 months. However, few high-income country studies reported an association after adjustment. Fewer studies evaluated the impact of long IPI on perinatal death and what evidence was available showed mixed results. Conclusions Results suggest a possible association between short IPI and risk of perinatal death following a live birth, particularly in low-to middle-income countries.

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“…Short IPI have been associated with prematurity, low birth weight, small for gestational age, infant admission to NICU and increased infant mortality [14,22,31,34,38,39]. Our data showed that a high rate of NICU admissions associated with short IPI may be partially related to GA.…”

Section: Interpregnancy Intervals Intention To Bf and Infant Feedingmentioning

confidence: 52%

“…We employed the most frequently used that determined the time in months elapsed from the date of the previous live birth to the onset of the pregnancy of the subsequent live birth [23]. If intervening obstetrical events such as stillbirth, miscarriages and induced abortions are ignored, the distribution of short IPI and the association of risk factors and IPI length could be affected [24, [29][30][31]. Thus, to facilitate interpretation of our data, we included only women without intervening obstetrical events between their previous and subsequent pregnancies.…”

Section: Various Methods Have Been Utilized To Assess the Intervals Bmentioning

confidence: 99%

Untitled

2020

Int J Women's Health Wellness

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Background: Interpregnancy intervals (IPI) have been related to adverse perinatal outcomes, however, correlation between IPI and BF initiation among women with pregestational diabetes (PGDM) have not been described. Objective: To determine associations of short (< 18 months), intermediate (18-59 months) and long (≥ 60 months) IPI with intention to breastfeed (BF) and with exclusive BF, partial BF or formula feeding (FF) at discharge. Methods: Retrospective cohort study of 205 women with PGDM who delivered (2013-2018) at ≥ 34 weeks GA. IPI was calculated as months elapsed between a live birth (previous) and the start of the pregnancy of the next live birth (subsequent). Results: IPI distribution was 34% short, 42% intermediate and 24% long. Short as compared to long IPI included more type 1 women (41 vs. 18%), younger women (31 vs. 34y), fewer BMI kg/m 2 ≥ 35 (46 vs. 64%) and more NICU admissions (26 vs. 2%). Prior BF experience was similar among the groups (short 63%, intermediate 59% and long IPI 54%). Intention to BF was similar for short and intermediate IPI (67 & 65%) and lower for long IPI (44%). At discharge comparing short vs. long IPI, exclusive BF was higher (37 vs. 18%), partial BF was similar (36 vs. 28%) and FF was lower (27 vs. 54%). Conclusions: Among women with PGDM, short IPI is associated with exclusive BF at discharge while long IPI was associated with lower intention to BF, lower rate of exclusive BF and higher rate of FF at discharge. IPI outside recommended guidelines affect perinatal outcomes and increase the risk for BF initiation failure.

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Effect of Interpregnancy Interval on Adverse Perinatal Outcomes in Southern China: A Retrospective Cohort Study, 2000–2015

Abstract: Women with IPI <18 months after live birth had higher risk of PTB and SGA, and IPI ≥60 months was associated with higher risk of PTB and LGA. These findings may provide information to Chinese couples about the appropriate interpregnancy interval for a second pregnancy.

Cited by 33 publications

References 35 publications

Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception

Interpregnancy intervals and women’s knowledge of the ideal timing between birth and conception

Interpregnancy interval and risk of perinatal death: a systematic review and meta‐analysis

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