Effect of inter-pregnancy interval on pregnancy outcome
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20250363Keywords:
Inter-pregnancy interval, Maternal health, Foetal health, Pregnancy outcomes, SpacingAbstract
Background: The inter-pregnancy interval (IPI) significantly impacts maternal and child health outcomes. Objective of the study was to determine the effect of inter-pregnancy interval on maternal and foetal outcome.
Methods: This prospective observational study was conducted at Sri Ramachandra Institute of Higher Education and Research Institute from September 2022 to April 2024. A total of 385 pregnant women in their second pregnancy were categorized into three groups based on the inter-pregnancy interval as short (<24 months), optimal (24-59 months), and long (>59 months). Data on maternal outcomes, intrapartum assessments, and foetal complications were collected and analysed using descriptive and comparative statistics.
Results: Out of 385 participants, 37.1% had an IPI of <24 months, 55.1% had an IPI of 24-59 months, and 7.8% had an IPI of >59 months. Shorter IPIs were associated with higher rates of anaemia (77%) and postpartum haemorrhage (45.8%). Longer IPIs were linked to increased gestational diabetes (50%) and hypertensive disorders (63.3%). Foetal complications such as macrosomia were more common in the longer IPIs group (16%).
Conclusions: Both short and long IPIs are linked with adverse maternal and foetal outcomes, emphasizing the need for optimal spacing between pregnancies to improve health outcomes.
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References
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. DOI: https://doi.org/10.1371/journal.pone.0228330
World Health Organization. Report of a WHO technical consultation on birth spacing. 2007. Available at: https://www.who.int/publications/i/ item/WHO-RHR-07.1.
Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89-94. DOI: https://doi.org/10.5830/CVJA-2016-021
Mihretie GN, Getie SA, Shiferaw S, Ayele AD, Liyeh TM, Kassa BG, et al. Interbirth interval practices among reproductive age women in rural and Urban kebeles in Farta Woreda: Casecontrol study. PLoS One. 2022;17(1):e0256193. DOI: https://doi.org/10.1371/journal.pone.0256193
Ministry of Health and Social Welfare. The National Road Map Strategic Plan To Accelerate Reduction of Maternal, Newborn and Child Deaths in Tanzania. 2008;1-102. Available at: https://www.prb.org/wp-content/uploads/2018/05/National-Road-Map-Strategic-Plan-to-Accelerate-Reduction-of-Maternal-Newborn-and-Child-Deaths-in-Tanzania-2016-2020-One-Plan-II. Accessed on 28 October 2024.
Gemmill A, Lindberg LD. Short Interpregnancy Intervals in the United States. Obstet Gynecol. 2013;122(1):64-71. DOI: https://doi.org/10.1097/AOG.0b013e3182955e58
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 Fam Med Prim Care. 2022;11(6):2917-22. DOI: https://doi.org/10.4103/jfmpc.jfmpc_2231_21
Dong H, Chi J, Wang W, Liu L. Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study. BMC Pregnancy Childbirth. 2023;23(1):284. DOI: https://doi.org/10.1186/s12884-023-05600-x
McKinney D, House M, Chen A, Muglia L, DeFranco E. The influence of interpregnancy interval on infant mortality. Am J Obstet Gynecol. 2017;216(3):316.e1-e9. DOI: https://doi.org/10.1016/j.ajog.2016.12.018
Khan MN, Khanam SJ. The effectiveness of WHO’s interpregnancy interval advice. Lancet Glob Health. 2023;11(10):e1476-7. DOI: https://doi.org/10.1016/S2214-109X(23)00402-3
Hutcheon JA, Nelson HD, Stidd R, Moskosky S, Ahrens KA. Short interpregnancy intervals and adverse maternal outcomes in highresource settings: An updated systematic review. Paediatr Perinat Epidemiol. 2019;33(1):48-59. DOI: https://doi.org/10.1111/ppe.12518
Hanley GE, Hutcheon JA, Kinniburgh BA, Lee L. Interpregnancy Interval and Adverse Pregnancy Outcomes: An Analysis of Successive Pregnancies. Obstet Gynecol. 2017;129(3):408-15. DOI: https://doi.org/10.1097/AOG.0000000000001891
Cormick G, Betrán AP, Ciapponi A, Hall DR, Hofmeyr GJ. Interpregnancy interval and risk of recurrent pre-eclampsia: systematic review and meta-analysis. Reprod Health. 2016;13:83. DOI: https://doi.org/10.1186/s12978-016-0197-x
Shachar BZ, Mayo JA, Lyell DJ, Baer RJ, Jeliffe-Pawlowski LL, Stevenson DK, et al. Interpregnancy interval after live birth or pregnancy termination and estimated risk of preterm birth: a retrospective cohort study. BJOG. 2016;123(12):2009-17. DOI: https://doi.org/10.1111/1471-0528.14165
Schummers L, Hutcheon JA, Hernandez-Diaz S, Williams PL, Hacker MR, VanderWeele TJ, et al. Association of Short Interpregnancy Interval with Pregnancy Outcomes According to Maternal Age. JAMA Intern Med. 2018;178(12):1661-70. DOI: https://doi.org/10.1001/jamainternmed.2018.4696
Gebremedhin AT, Regan AK, Malacova E, Marinovich ML, Ball S, Foo D, et al. Effects of interpregnancy interval on pregnancy complications: protocol for systematic review and meta-analysis. BMJ Open. 2018;8(8):e025008. DOI: https://doi.org/10.1136/bmjopen-2018-025008
Latif S, Aiken C. Prolonged pregnancy: balancing risks and interventions for post-term gestations. Obstet Gynaecol Reprod Med. 2024;34(5):127-33. DOI: https://doi.org/10.1016/j.ogrm.2024.02.004
Wendt A, Gibbs CM, Peters S, Hogue CJ. Impact of Increasing Inter-pregnancy Interval on Maternal and Infant Health. Paediatr Perinat Epidemiol. 2012;26(s1):239-58. DOI: https://doi.org/10.1111/j.1365-3016.2012.01285.x
Tedde JGG, Cerqueira-Silva T, Lagrosa Garcia SA, Amira BV, Rodrigues LC, Barreto ML, et al. Association of interpregnancy interval with adverse pregnancy outcomes according to the outcomes of the preceding pregnancy: a longitudinal study with 4.7 million live births from Brazil. Lancet Reg Health Am. 2024;30:100687. DOI: https://doi.org/10.1016/j.lana.2024.100687
Tessema GA, Marinovich ML, Håberg SE, Gissler M, Mayo JA, Nassar N, et al. Interpregnancy intervals and adverse birth outcomes in high-income countries: An international cohort study. PLoS One. 2021;16(7):e0255000. DOI: https://doi.org/10.1371/journal.pone.0255000