Impact of interpregnancy interval on maternal and perinatal outcomes
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20232934Keywords:
Interpregnancy interval, Normal interpregnancy interval, Short interpregnancy intervalAbstract
Background: Inter-pregnancy interval (IPI) refers to the duration between the birth of one baby and the conception of the next pregnancy. In developing countries, a short inter-pregnancy interval (SIPI) poses a significant challenge, leading to higher risks of maternal and neonatal mortality. Aim was to determine the impact of SIPI on maternal and perinatal outcomes.
Methods: This prospective observational comparative study was carried out from October 2020 to May 2022. Non-probability convenient sampling was used, and the minimum sample size was calculated to be 140. Primigravida, multiple gestations, molar pregnancies, and those with major complications were excluded. The study compared two groups: cases (70 women with IPI ≤18 months) and controls (70 women with IPI between ≥19 months to ≤59 months). A p value <0.05 was considered statistically significant.
Results: Higher proportion of younger mothers had lower IPI as compared to those who were older. Higher proportion of mothers with short IPI had anaemia (p value- 0.017) while lower proportion had pregnancy induced hypertension (PIH) (p value- 0.001). On logistic regression analysis, patients with SIPI had lesser risk of PIH (p value- 0.036, OR: 0.266), higher risk of obstetric cholestasis (p value- 0.006, OR: 4.186) and higher risk of scar dehiscence/tenderness (p value- 0.003, OR: 10.666).
Conclusions: Mothers with a short interpregnancy interval of 18 months or less experienced significant morbidity and adverse perinatal outcomes, such as scar dehiscence and obstetric cholestasis. However, the incidence of pregnancy-induced hypertension (PIH) was notably lower in this group.
Metrics
References
Isiugo-Abanihe UC, Nwokocha EE. Prevalence and consequences of ewu-ukwu custom in Mbaise, Imo State, Nigeria. Niger J Sociol Anthropol. 2008;6(1):53-70.
Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA. 2006;295(15):1809-23.
Smits LJ, Essed GG. Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion. Lancet. 2001;358(9298):2074-7.
Yohannes S, Wondafrash M, Abera M, Girma E. Duration and determinants of birth interval among women of child bearing age in Southern Ethiopia. BMC Pregnancy Childbirth. 2011;11(1):1-6.
Kaharuza F. Short interpregnancy intervals and child survival. Int J Obstet Gynaecol. 2001;1(09):1-60.
Yerushalmy J. Births, infant mortality, and maternal mortality in the United States: 1942. Public Health Rep (1896-1970). 1944;59(25):797.
Dewey KG, Cohen RJ. Does birth spacing affect maternal or child nutritional status? A systematic literature review. Matern Child Nutr 2007;3(3):151-73.
World Bank Group Approach and Action Plan for Climate Change and Health. World Bank, Washington DC; 2017.
Cleland J, Bernstein S, Ezeh A, Faundes A, Glasier A, Innis J. Family planning: the unfinished agenda. Lancet 2006;368(9549):1810-27.
Matthews Z, Padmadas SS, Hutter I, McEachran J, Brown JJ. Does early childbearing and a sterilization-focused family planning programme in India fuel population growth? Demogr Res. 2009;20:693-720.
Lewis P, Mor S. Study on fetomaternal outcome in short interpregnancy interval: case control study. Int J Reprod Contracept Obstet Gynecol. 2020;9(2):583-8.
Elumalai BT, Govindarajan V. The impact of interpregnancy interval on occurrence of preterm births in the present pregnancy. Int J Reprod Contracept Obstet Gynecol. 2021;10(5):2020-6.
Nausheen S, Bhura M, Hackett K, Hussain I, Shaikh Z, Rizvi A, et al. Determinants of short birth intervals among married women: a cross-sectional study in Karachi, Pakistan. BMJ Open. 2021;11(4):e043786.
Winkvist A, Rasmussen KM, Habicht JP. A new definition of maternal depletion syndrome. Am J Public Health. 1992;82(5):691-4.
Klerman LV, Cliver SP, Goldenberg RL. The impact of short interpregnancy intervals on pregnancy outcomes in a low-income population. Am J Public Health. 1998;88(8):1182-5.
Sanga LA, Mtuy T, Philemon RN, Mahande MJ. Inter-pregnancy interval and associated adverse maternal outcomes among women who delivered at Kilimanjaro Christian Medical Centre in Tanzania, 2000-2015. Plos one. 2020;15(2):e0228330.
Mor S, Lewis PF. Study on fetomaternal outcome in long interpregnancy interval: case control study. Int J Sci Res. 2020;9(1):1859-62.
Hutcheon JA, Nelson HD, Stidd R, Moskosky S, Ahrens KA. Short interpregnancy intervals and adverse maternal outcomes in high‐resource settings: an updated systematic review. Paediatr Perinat Epidemiol. 2019;33(1):O48-59.
Gebremedhin AT, Regan AK, Ball S, Betrán AP, Foo D, Gissler M, et al. Effect of interpregnancy interval on gestational diabetes: a retrospective matched cohort study. Ann Epidemiol. 2019;39:33-8.
Hanley GE, Hutcheon JA, Kinniburgh BA, Lee L. Interpregnancy interval and adverse pregnancy outcomes. Obstet Gynecol. 2017;129(3):408-15.
Grisaru-Granovsky S, Gordon ES, Haklai Z, Samueloff A, Schimmel MM. Effect of interpregnancy interval on adverse perinatal outcomes--a national study. Contraception. 2009;80(6):512-8.
Haq A, Lallar M, Akhter S, Baba YZ, Ahmad J, Hamid MA. Interpregnancy interval raise odds of adverse perinatal outcome in high fertility region Mewat, Haryana. Int J Reprod Contracept Obstet Gynecol. 2014;3(3):598-603.
Mahande MJ, Obure J. Effect of interpregnancy interval on adverse pregnancy outcomes in northern Tanzania: a registry-based retrospective cohort study. BMC Pregnancy Childbirth. 2016;16(1):1-9.
Ekin A, Gezer C, Taner CE, Ozeren M, Mat E, Solmaz U. Impact of interpregnancy interval on the subsequent risk of adverse perinatal outcomes. J Obstet Gynaecol Res. 2015;41(11):1744-51.
Thapaliya R, Rai BK, Bhandari R, Rijal P, Gupta PP. The effect of birth interval on fetal outcomes. Health Renaiss. 2015;13(3):169-76.
Ramsay JE, Ferrell WR, Crawford L, Wallace AM, Greer IA, Sattar N. Maternal obesity is associated with dysregulation of metabolic, vascular, and inflammatory pathways. J Clin Endocrinol Metab. 2002;87(9):4231-7.
Shree R, Caughey AB, Chandrasekaran S. Short interpregnancy interval increases the risk of preterm premature rupture of membranes and early delivery. J Matern Fet Neonat Med. 2018;31(22):3014-20.
Appareddy S, Pryor J, Bailey B. Inter-pregnancy interval and adverse outcomes: evidence for an additional risk in health disparate populations. J Matern Fet Neonat Med. 2017;30(21):2640-4.
Adam I, Ismail MH, Nasr AM, Prins MH, Smits LJ. Low birth weight, preterm birth and short interpregnancy interval in Sudan. J Matern Fet Neonat Med. 2009;22(11):1068-71.
Chandna A, Mittal R, Sood A, Sood P. Inter-pregnancy interval and pregnancy outcome. Int J Reprod Contracept Obstet Gynecol. 2016;5(2):415-9.
Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Effects of birth spacing on maternal health: a systematic review. Am J Obstet Gynecol. 2007;196(4):297-308.
DaVanzo J, Hale L, Razzaque A, Rahman M. The effects of pregnancy spacing on infant and child mortality in Matlab, Bangladesh: how they vary by the type of pregnancy outcome that began the interval. Popul Stud. 2008;62(2):131-54.
Downloads
Published
How to Cite
Issue
Section
