Interpregnancy interval and birth defects

Mburia-Mwalili, Adel; Yang, Wei

doi:10.1002/bdra.23420

Cited by 13 publications

(15 citation statements)

References 29 publications

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“…Fertility effects are difficult to document, but parental subfertility was seen with VACTERL [35], and with anorectal defects with other major anomalies [47]. Similarly, singletons born of infertile couples had increasing congenital anomalies with rising times to pregnancy [21], which was also an independent risk for birth defects [65]. This also held for ART in a meta-analysis [66].…”

Section: Vacterl and Adverse Outcomesmentioning

confidence: 98%

An epigenetic association of malformations, adverse reproductive outcomes, and fetal origins hypothesis related effects

Lubinsky

2018

J Assist Reprod Genet

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VACTERL, the prototype for associated congenital anomalies, also has connections with functional issues such as pregnancy losses, prematurity, growth delays, perinatal difficulties, and parental subfertility. This segues into a broader association with similar connections even in the absence of malformations. DNA methylation disturbances in the ovum are a likely cause, with epigenetic links to individual components and to folate effects before conception, explaining diverse fetal and placental findings and providing a link to fetal origin hypothesis-related effects. The association encompasses the following: (1) Pre- and periconceptual effects, with frequent fertility issues and occasional imprinting disorders. (2) Early malformations. (3) Adverse pregnancy outcomes (APOs), as above. (4) Developmental destabilization that resolves soon after birth. This potentiates other causes of association findings, introducing multiple confounders. (5) Long-term fetal origins hypothesis-related risks. The other findings are exceptional when the same malformations have Mendelian origins, supporting a distinct pathogenesis. Expressions are facilitated by one-carbon metabolic issues, maternal and fetal stress, and decreased embryo size. This may be one of the commonest causes of adverse reproductive outcomes, but multifactorial findings, variable onsets and phenotypes, and interactions with multiple confounders make recognition difficult. This association supports VACTERL as a continuum that includes isolated malformations, extends the fetal origins hypothesis, explains adverse effects linked to maternal obesity, and suggests possible interventions.

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Section: Vacterl and Adverse Outcomesmentioning

confidence: 98%

An epigenetic association of malformations, adverse reproductive outcomes, and fetal origins hypothesis related effects

Lubinsky

2018

J Assist Reprod Genet

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“…[8][9][10][11]21,22,25,[27][28][29][34][35][36][37][38][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62] The majority of studies were conducted in the United States (n = 18), 11,21,25,[27][28][29][36][37][38]49,51,[54][55][56][57][58][59]62 78% of which used U.S. birth certificate data (n = 14). 11,21,…”

Section: Re Sultsmentioning

confidence: 99%

“…Nine of the 32 studies met criteria for good internal validity, [8][9][10][11]22,28,34,35,46 18 fair 21,25,27,29,36,37,[47][48][49][50][51][52][53][54]57,58,60,61 and five poor 38,55,56,59,62 (Table 1). Most studies included a limited set of covariates for adjustment, and no study accounted for all the study design considerations outlined above.…”

Section: Re Sultsmentioning

confidence: 99%

“…Additional good or fair quality studies examined the following outcomes: alternative preterm birth definitions (n = 6); 25,34,46,50,51,57 birthweight (n = 2); 27,52 low birthweight (including alternative definitions such as very low birthweight) (n = 13); [8][9][10]22,27,34,36,37,46,48,50,51,61 alternative small-for-gestational age definitions (n = 1); 50 neonatal intensive care unit (n = 3); 9,50,51 Apgar score (n = 1); 50 and congenital anomalies (n = 3). 34,58,60 Estimates reported from each study are presented in a supplemental table (Table S1). As with the adverse perinatal outcomes already described, the highest risks (mostly aOR<2.0) were found for the shortest interpregnancy intervals, and there was attenuation of estimates after adjustment for confounders.…”

Section: Other Perinatal Outcomesmentioning

confidence: 99%

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Short interpregnancy intervals and adverse perinatal outcomes in high‐resource settings: An updated systematic review

Ahrens

Nelson

Stidd

et al. 2018

Paediatric Perinatal Epid

109

113

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Background This systematic review summarises association between short interpregnancy intervals and adverse perinatal health outcomes in high‐resource settings to inform recommendations for healthy birth spacing for the United States. Methods Five databases and a previous systematic review were searched for relevant articles published between 1966 and 1 May 2017. We included studies meeting the following criteria: (a) reporting of perinatal health outcomes after a short interpregnancy interval since last livebirth; (b) conducted within a high‐resource setting; and (c) estimates were adjusted for maternal age and at least one socio‐economic factor. Results Nine good‐quality and 18 fair‐quality studies were identified. Interpregnancy intervals <6 months were associated with a clinically and statistically significant increased risk of adverse outcomes in studies of preterm birth (eg, aOR ≥ 1.20 in 10 of 14 studies); spontaneous preterm birth (eg, aOR ≥ 1.20 in one of two studies); small‐for‐gestational age (eg, aOR ≥ 1.20 in 5 of 11 studies); and infant mortality (eg, aOR ≥ 1.20 in four of four studies), while four studies of perinatal death showed no association. Interpregnancy intervals of 6‐11 and 12‐17 months generally had smaller point estimates and confidence intervals that included the null. Most studies were population‐based and few included adjustment for detailed measures of key confounders. Conclusions In high‐resource settings, there is some evidence showing interpregnancy intervals <6 months since last livebirth are associated with increased risks for preterm birth, small‐for‐gestational age and infant death; however, results were inconsistent. Additional research controlling for confounding would further inform recommendations for healthy birth spacing for the United States.

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“…Fewer studies evaluated additional outcomes including infant mortality, cesarean delivery rates, or the impact of interventions [ 30 - 33 ]. Only one study [ 34 ] assessed the effect of IPI and congenital malformations. While this study analyzed data from a large state database that included women of lower socioeconomic status and of varying racial and ethnic groups, the authors did not specifically evaluate the incidence of malformations in high risk subpopulations with extreme IPIs.…”

Section: Resultsmentioning

confidence: 99%

The Role of Extremes in Interpregnancy Interval in Women at Increased Risk for Adverse Obstetric Outcomes Due to Health Disparities: A Literature Review

Thagard

Napolitano

Bryant

2018

CWHR

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Background: The interpregnancy interval (IPI) defines the time between two consecutive gestations. In the general population, women with IPIs that fall outside the recommended 18-24 month range appear to be at modestly increased risk for adverse obstetric outcomes.Objective: The aim of this review was to assess the impact of extremes in IPI in populations with an increased baseline risk for adverse obstetric outcomes due to disparities in health and health care, including racial and ethnic groups, adolescents, and those of lower socioeconomic status.Methods: We conducted a MEDLINE/Pubmed literature search in February 2016. Identified articles were reviewed and assigned a level of evidence.Results: The 24 studies included in our final review were mainly retrospective with considerable heterogeneity in definitions and outcomes that prevented a quantitative meta-analysis.Conclusion: The results of our review suggest that at-risk populations may have an increased frequency of shortened IPIs though the impact appears to be moderate and inconsistent. There was insufficient evidence to draw meaningful conclusions regarding a prolonged IPI or the effect of interventions. Based on the current literature, under-served populations are more likely to have a shortened IPI which increased the incidence of prematurity and low birth weight in some groups though the effect on additional obstetric outcomes is difficult to assess

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Interpregnancy interval and birth defects

Abstract: A long interpregnancy interval is an independent risk factor for birth defects. It may be helpful for maternal and child health programs and health care providers to highlight the deleterious effects of a long interpregnancy interval.

Cited by 13 publications

References 29 publications

An epigenetic association of malformations, adverse reproductive outcomes, and fetal origins hypothesis related effects

An epigenetic association of malformations, adverse reproductive outcomes, and fetal origins hypothesis related effects

Short interpregnancy intervals and adverse perinatal outcomes in high‐resource settings: An updated systematic review

The Role of Extremes in Interpregnancy Interval in Women at Increased Risk for Adverse Obstetric Outcomes Due to Health Disparities: A Literature Review

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