Effect of interpregnancy interval on gestational diabetes: a retrospective matched cohort study

Regan, Annette K.; Ball, Stephen; Betrán, Ana Pilar; Foo, Damien; Gissler, Mika; Håberg, Siri E.; Malacova, Eva; Marinovich, M. Luke; Pereira, Gavin

doi:10.1016/j.annepidem.2019.09.004

Cited by 17 publications

(34 citation statements)

References 26 publications

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“… 20 Gebremedhin et al reported that the associations between short IPIs and hypertensive disorders of pregnancy and gestational diabetes were not statistically significant based on within-mother matched analyses and suggested that associations observed in previous studies may have been due to confounding factors. 31 , 32 Due to the limitations of the pre-set questions, several influencing factors had not been included in this study. Studies with better investigations and better designs will be needed in the future to analyze the correlation between IPI and adverse birth outcomes.…”

Section: Discussionmentioning

confidence: 99%

Association of Short and Long Interpregnancy Intervals with Adverse Birth Outcomes: Evidence from a Cross-Sectional Study in Northwest China

Shi

Zhang

Kang

et al. 2021

IJGM

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Purpose To analyze the effects of a short interpregnancy interval (IPI) (<6 months) and a long IPI (>120 months) on neonatal adverse birth outcomes including low birth weight (LBW), small for gestational age (SGA), preterm birth (PTB), and birth defects in Shaanxi Province. Patients and Methods A stratified multistage random sampling method was used to recruit participants who gave birth between 2010 and 2013 in Shaanxi province. A self-designed questionnaire was used to collect the information of the participants. With the confounding factors controlled, the generalized linear model (GLM) was used to investigate the association between IPI and neonatal birth outcomes. The restricted cubic spline (RCS) function was used to evaluate the dose–response relationship between IPI and birth outcomes. Results A total of 13,231 women were included. The prevalence of LBW, SGA, PTB, and birth defects was 3.24%, 12.96%, 2.93%, and 2.12%, respectively. GLM showed that a short IPI (<6 months) was associated with a higher risk of SGA (RR=1.25, 95% CI: 1.04–1.52) and birth defects (RR=2.55, 95% CI: 1.45–4.47), and a long IPI (≥120 months) was associated with a higher risk of LBW (RR=1.54, 95% CI: 1.01–2.34) and PTB (RR=1.73, 95% CI: 1.08–2.76) than an IPI of 18–23 months. The RCS showed that LBW, SGA, and PTB demonstrated a j-shaped relationship with IPI (P for overall association < 0.001 for these three birth outcomes), and birth defects (P for overall association <0.001) had an inversely non-linear relationship with IPI. Conclusion Both short and long IPIs are associated with an increased risk of adverse birth outcomes.

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Section: Discussionmentioning

confidence: 99%

Association of Short and Long Interpregnancy Intervals with Adverse Birth Outcomes: Evidence from a Cross-Sectional Study in Northwest China

Shi

Zhang

Kang

et al. 2021

IJGM

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“…29 Data sources and the study protocol have been described elsewhere. 30,31 Our analyses included all mothers with at least two consecutive IPIs at 20-44 weeks of gestation in WA within the period 1980 and 2015. Of the original total of 487 297 mothers, we sequentially excluded mothers who delivered multiples; mothers who delivered only once during the study period; mothers whose children's birth years were inconsistent with parity; mothers whose IPIs were negative; and mothers who had missing gestational length, birth outcomes, age, infant sex, and socio-economic status.…”

Section: Data Sources and Analytic Samplementioning

confidence: 99%

Interpregnancy interval and hypertensive disorders of pregnancy: A population‐based cohort study

Gebremedhin

Regan

Ball

et al. 2020

Paediatric Perinatal Epid

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Background: Despite extensive research on risk factors and mechanisms, the extent to which interpregnancy interval (IPI) affects hypertensive disorders of pregnancy in high-income countries remains unclear.Objectives: To examine the association between IPI and hypertensive disorders of pregnancy in a high-income country setting using both within-mother and betweenmother comparisons. Methods: A retrospective population-based cohort study was conducted among 103 909 women who delivered three or more consecutive singleton births (n = 358 046) between 1980 and 2015 in Western Australia. We used conditional Poisson regression with robust variance, matching intervals of the same mother and adjusted for factors that vary within-mother across pregnancies, to investigate the association between IPI categories (reference 18-23 months), and the risk of hypertensive disorders of pregnancy. For comparison with previous studies, we also applied unmatched Poisson regression (between-mother analysis). Results:The incidence of preeclampsia and gestational hypertension during the study period was 4%, and 2%, respectively. For the between-mother comparison, mothers with intervals of 6-11 months had lower risk of preeclampsia with adjusted relative risk (RR) 0.92 (95% confidence interval [CI] 0.85, 0.98) compared to reference category of 18-23 months. With the within-mother matched design, we estimated a larger effect of long IPI on risk of preeclampsia (RR 1.29, 95% CI 1.18, 1.42 for 60-119 months; and RR 1.30, 95% CI 1.10, 1.53 for intervals ≥120 months) | 405 GEBREMEDHIN Et al.

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“…[5][6][7][8] Interpregnancy interval (IPI), the length of time between pregnancies, has been identified as a potentially modifiable risk factor for adverse perinatal outcomes, with short and long IPIs found to be associated with adverse outcomes. [9][10][11][12] Based on these associations, various clinical guidelines and WHO recommend that women wait at least 18-24 months before conceiving another child. [13][14][15] Recently, there has been growing literature on the association between IPIs and recurrence of pregnancy complications.…”

Section: Introductionmentioning

confidence: 99%

Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study

2021

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ObjectiveTo examine if the association between interpregnancy interval (IPI) and pregnancy complications varies by the presence or absence of previous complications.Design and settingPopulation-based longitudinally linked cohort study in Western Australia (WA).ParticipantsMothers who had their first two (n=252 368) and three (n=96 315) consecutive singleton births in WA between 1980 and 2015.Outcome measuresWe estimated absolute risks (AR) of preeclampsia (PE) and gestational diabetes (GDM) for 3–60 months of IPI according to history of each outcome. We modelled IPI using restricted cubic splines and reported adjusted relative risk (RRs) with 95% CI at 3, 6, 12, 24, 36, 48 and 60 months, with 18 months as reference.ResultsRisks of PE and GDM were 9.5%, 2.6% in first pregnancies, with recurrence rates of 19.3% and 41.5% in second pregnancy for PE and GDM, respectively. The AR of GDM ranged from 30% to 43% across the IPI range for mothers with previous GDM compared with 2%–8% for mothers without previous GDM. For mothers with no previous PE, greater risks were observed for IPIs at 3 months (RR 1.24, 95% CI 1.07 to 1.43) and 60 months (RR 1.40, 95% CI 1.29 to 1.53) compared with 18 months. There was insufficient evidence for increased risk of PE at shorter IPIs of <18 months for mothers with previous PE. Shorter IPIs of <18 months were associated with lower risk than at IPIs of 18 months for mothers with no previous GDM.ConclusionsThe associations between IPIs and risk of PE or GDM on subsequent pregnancies are modified by previous experience with these conditions. Mothers with previous complications had higher absolute, but lower RRs than mothers with no previous complications. However, IPI remains a potentially modifiable risk factor for mothers with previous complicated pregnancies.

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Effect of interpregnancy interval on gestational diabetes: a retrospective matched cohort study

Cited by 17 publications

References 26 publications

Association of Short and Long Interpregnancy Intervals with Adverse Birth Outcomes: Evidence from a Cross-Sectional Study in Northwest China

Association of Short and Long Interpregnancy Intervals with Adverse Birth Outcomes: Evidence from a Cross-Sectional Study in Northwest China

Interpregnancy interval and hypertensive disorders of pregnancy: A population‐based cohort study

Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study

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