Effects of Interpregnancy Interval and Outcome of the Preceding Pregnancy on Pregnancy Outcomes in Matlab, Bangladesh

Overview

Journal BJOG

Specialty Gynecology & Obstetrics

Date 2007 Jul 10

PMID 17617195

Citations 118

Authors

J Davanzo

L Hale

A Razzaque

M Rahman

Affiliations

Soon will be listed here.

Abstract

Objective: To estimate the effects on pregnancy outcomes of the duration of the preceding interpregnancy interval (IPI) and type of pregnancy outcome that began the interval.

Design: Observational population-based study.

Setting: The Maternal Child Health-Family Planning (MCH-FP) area of Matlab, Bangladesh.

Population: A total of 66,759 pregnancy outcomes that occurred between 1982 and 2002.

Methods: Bivariate tabulations and multinomial logistic regression analysis.

Main Outcome Measures: Pregnancy outcomes (live birth, stillbirth, miscarriage [spontaneous fetal loss prior to 28 weeks], and induced abortion).

Results: When socio-economic and demographic covariates are controlled, of the IPIs that began with a live birth, those < 6 months in duration were associated with a 7.5-fold increase in the odds of an induced abortion (95% CI 6.0-9.4), a 3.3-fold increase in the odds of a miscarriage (95% CI 2.8-3.9), and a 1.6-fold increase in the odds of a stillbirth (95% CI 1.2-2.1) compared with 27- to 50-month IPIs. IPIs of 6-14 months were associated with increased odds of induced abortion (2.0, 95% CI 1.5-2.6). IPIs > or = 75 months were associated with increased odds of all three types of non-live-birth (NLB) outcomes but were not as risky as very short intervals. IPIs that began with a NLB were generally more likely to end with the same type of NLB.

Conclusions: Women whose pregnancies are between 15 and 75 months after a preceding pregnancy outcome (regardless of its type) have a lower likelihood of fetal loss than those with shorter or longer IPIs. Those with a preceding NLB outcome deserve special attention in counselling and monitoring.

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References

Leridon H . Facts and artifacts in the study of intra-uterine mortality: A reconsideration from pregnancy histories. Popul Stud (Camb). 2011; 30(2):319-35. DOI: 10.1080/00324728.1976.10412738. View

George L, Granath F, Johansson A, Olander B, Cnattingius S . Risks of repeated miscarriage. Paediatr Perinat Epidemiol. 2006; 20(2):119-26. DOI: 10.1111/j.1365-3016.2006.00703.x. View

Abebe G, Yohannis A . Birth interval and pregnancy outcome. East Afr Med J. 1996; 73(8):552-5. View

Khoshnood B, Lee K, Wall S, Hsieh H, Mittendorf R . Short interpregnancy intervals and the risk of adverse birth outcomes among five racial/ethnic groups in the United States. Am J Epidemiol. 1998; 148(8):798-805. DOI: 10.1093/oxfordjournals.aje.a009701. View

Conde-Agudelo A, Belizan J, Breman R, Brockman S, Rosas-Bermudez A . Effect of the interpregnancy interval after an abortion on maternal and perinatal health in Latin America. Int J Gynaecol Obstet. 2005; 89 Suppl 1:S34-40. DOI: 10.1016/j.ijgo.2004.08.003. View

Smits L, Essed G . Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion. Lancet. 2002; 358(9298):2074-7. DOI: 10.1016/S0140-6736(01)07105-7. View

Swenson I, Harper P . The relationship between fetal wastage and pregnancy spacing in Bangladesh. Soc Biol. 1978; 25(3):251-7. DOI: 10.1080/19485565.1978.9988344. View

Miller J . Birth intervals and perinatal health: an investigation of three hypotheses. Fam Plann Perspect. 1991; 23(2):62-70. View

Casterline J . Collecting data on pregnancy loss: a review of evidence from the World Fertility Survey. Stud Fam Plann. 1989; 20(2):81-95. View

10.

DSouza S . A population laboratory for studying disease processes and mortality--the Demographic Surveillance System, Matlab Comilla, Bangladesh. Rural Demogr. 1981; 8(1):29-51. View

11.

Conde-Agudelo A, Rosas-Bermudez A, Kafury-Goeta A . Effects of birth spacing on maternal health: a systematic review. Am J Obstet Gynecol. 2007; 196(4):297-308. DOI: 10.1016/j.ajog.2006.05.055. View

12.

Winkvist A, Rasmussen K, Habicht J . A new definition of maternal depletion syndrome. Am J Public Health. 1992; 82(5):691-4. PMC: 1694126. DOI: 10.2105/ajph.82.5.691. View

13.

Casterline J . Maternal age, gravidity, and pregnancy spacing effects on spontaneous fetal mortality. Soc Biol. 1989; 36(3-4):186-212. DOI: 10.1080/19485565.1989.9988731. View

14.

Zimmer B . Consequences of the number and spacing of pregnancies on outcome, and of pregnancy outcome on spacing. Soc Biol. 1979; 26(2):161-78. DOI: 10.1080/19485565.1979.9988374. View

15.

Kashanian M, Akbarian A, Baradaran H, Shabandoust S . Pregnancy outcome following a previous spontaneous abortion (miscarriage). Gynecol Obstet Invest. 2006; 61(3):167-70. DOI: 10.1159/000091074. View

16.

Bhatia S . Contraceptive users in rural Bangladesh: a time trend analysis. Stud Fam Plann. 1983; 14(1):20-8. View

17.

Kallan J . Effects of interpregnancy intervals on preterm birth, intrauterine growth retardation, and fetal loss. Soc Biol. 1992; 39(3-4):231-45. View

18.

Razzaque A, Da Vanzo J, Rahman M, Gausia K, Hale L, Khan M . Pregnancy spacing and maternal morbidity in Matlab, Bangladesh. Int J Gynaecol Obstet. 2005; 89 Suppl 1:S41-9. DOI: 10.1016/j.ijgo.2005.01.003. View

19.

Conde-Agudelo A, Belizan J . Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ. 2000; 321(7271):1255-9. PMC: 27528. DOI: 10.1136/bmj.321.7271.1255. View

20.

Kallan J . Reexamination of interpregnancy intervals and subsequent birth outcomes: evidence from U.S. linked birth/infant death records. Soc Biol. 1998; 44(3-4):205-12. View