Contraceptive trends and fetal outcome in women with short and long interpregnancy interval: a prospective observational study
Keywords:Chi square test, Contraception, Interpregnancy interval, Large for gestational age, Low birth weight, preterm
Background: The present study was conducted at our tertiary health centre with the objective of analyzing contraceptive trends and fetal outcome in women with various interpregnancy interval (IPI).
Methods: The present study was a prospective observational study. Women were segregated into three categories as per their IPI (short, normal and long) and contraceptive trends and fetal outcome were deliberated. All women attending ANC clinic with previous pregnancy, regardless of outcome and registration status were included in our study.
Results: We found that 21.1% of women with short IPI were unaware about contraception and this difference was statistically significant. It was seen that among women not using any method of contraception, majority had short ICP, almost 31.1% cases. This difference was also statistically significant. Amidst those with adverse outcomes of previous pregnancy, i.e. 169 cases, 87 cases i.e. 51.5% of the women conceived within 2 years. Short IPI is linked with an escalated risk of low birth weight, preterm birth and congenital anomaly whereas long IPI caused large for gestational age babies.
Conclusions: Contraception and previous pregnancy outcome have a significant effect on interpregnancy interval which in turn affects the maternal and fetal outcome. So it is essential to maintain an optimum interpregnancy interval as most of these complications are avoidable. Short interpregnancy interval is associated with low birth weight, preterm and congenital anomaly whereas long interpregnancy interval is associated with large for gestational age babies.
Eleje GU, Ezebiala IU, Eke NO, Interpregnancy Interval(IPI):What is the ideal?; Afrimedic J. 2011;2(1):36-8.
Conde‐Agudelo A, Rosas‐Bermudez A, Castaño F, Norton MH. Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms. Stud Fami Plann. 2012;43(2):93-114.
de Bocanegra HT, Chang R, Howell M, Darney P. Interpregnancy intervals: impact of postpartum contraceptive effectiveness and coverage. Ame J Obstet Gynecol. 2014;210(4):311-e1.
DaVanzo J, Hale L, Razzaque A, Rahman M. Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG. 2007;114:1079-87.
World Health Organization. Fact sheets- family planning/ contraception, 2014. Available at: https://www.who.int/news-room/fact-sheets/detail/family-planning-contraception. Accessed on 5th September 2023.
United Nations Population Division (UNPD). Department of Economic and Social Affairs. World Contraceptive Use 2015 (POP/DB/CP/Rev2015), 2015.
Ramesh BM, Gulati SC, Retherford RD. Contraceptive use in India, 1992-93.
Ewerling F, McDougal L, Raj A, Ferreira LZ, Blumenberg C, Parmar D, et al. Modern contraceptive use among women in need of family planning in India: an analysis of the inequalities related to the mix of methods used. Reproductive health. 2021;18(1):1-2.
Ministry of Health and family welfare. Annual Report 2015-16-Family planning. (chapter 6);2015-16. Available at: https://nhm.gov.in/images/pdf/programmes/family-planing/annual-report/annual-report-fp-division-2015-16.pdf. Accessed on 15th October 2016.
Amani Idris Kikula et al. Short inter-pregnancy interval: why is it still high among women in Dar es Salaam?. Pan Afr Med J 2021;40(17).
Thulaseedharan JV. Contraceptive use and preferences of young married women in Kerala, India. Open Access J Contracept. 2018;9:1-10.
Ewerling F, McDougal L, Raj A, Ferreira LZ, Blumenberg C, Parmar D, et al. Modern contraceptive use among women in need of family planning in India: an analysis of the inequalities related to the mix of methods used. Reproduct Heal. 2021;18(1):1-2.
Setty-Venugopal V, Upadhyay UD. Birth spacing: three to five saves lives. Population Reports. Series L: Issues in World Health. 2002(13):1-23.
Chuks J. Ghana's reproductive revolution: analysis of the determinants of fertility transition. African Population Studies. 2002;17(1):47-67.
Singh SN, Singh SN, Narendra RK. Demographic and socio-economic determinants of birth interval dynamics in Manipur: A survival analysis. J Heal Alli Sci. 2011;9(4).
Agrawal S, Chaudhary M, Das V, Agarwal A, Pandey A, Kumar N, et al. Association of long and short interpregnancy intervals with maternal outcomes. J Family Med Prim Care. 2022;11(6):2917-22.
Gurmu L, Wakgari N, Kolola T, Danusa KT. Effect of short inter-pregnancy interval on perinatal outcomes among pregnant women in North-west Ethiopia: A prospective cohort study. Front Publ Heal. 2022;10:953481.
Rashid R, Nazim M, Sofi JA. Evaluation of neonatal admission to neonatal intensive care unit in a tertiary care hospital in Kashmir. Int J Reprod Contracept Obstet Gynecol. 2022;11(2):527-30.
Bharati P, Pal M, Bandyopadhyay M, Bhakta A, Chakraborty S. Prevalence and causes of low birth weight in India. Malaysian J Nutrit. 2011;17(3).
Hanley GE, Hutcheon JA, Kinniburgh BA, Lee L. Interpregnancy interval and adverse pregnancy outcomes. Obstet Gynecol. 2017;129(3):408-15.
Lilungulu A, Matovelo D, Kihunrwa A, Gumodoka B. Spectrum of maternal and perinatal outcomes among parturient women with preceding short inter-pregnancy interval at Bugando Medical Centre, Tanzania. Mater Heal Neonatol Perinatol. 2015;1(1):1.
Zhang Q, Dang S, Bai R, Mi B, Wang L, Yan H. Association between maternal interpregnancy interval after live birth or pregnancy termination and birth weight: a quantile regression analysis. Scienti Repo. 2018;8(1):4130.
Coo H, Brownell MD, Ruth C, Flavin M, Au W, Day AG. Interpregnancy interval and congenital anomalies: a record-linkage study using the Manitoba population research data repository. J Obstet Gynaecol Cana. 2017;39(11):996-1007.