Interpregnancy interval and adverse perinatal outcomes: A within-individual comparative method

Maria Sevoyan; Marco Geraci; Edward A Frongillo; Jihong Liu; Nansi S Boghossian

doi:10.1002/hsr2.2313

Interpregnancy interval and adverse perinatal outcomes: A within-individual comparative method

Health Sci Rep. 2024 Aug 19;7(8):e2313. doi: 10.1002/hsr2.2313. eCollection 2024 Aug.

Authors

Maria Sevoyan¹, Marco Geraci^{1

2}, Edward A Frongillo³, Jihong Liu¹, Nansi S Boghossian¹

Affiliations

¹ Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia South Carolina USA.
² MEMOTEF Department, School of Economics Sapienza University of Rome Roma Italy.
³ Department of Health Promotion, Education, and Behavior Arnold School of Public Health, University of South Carolina Columbia South Carolina USA.

Abstract

Background and aim: Previously observed associations between interpregnancy interval (IPI) and perinatal outcomes using a between-individual method may be confounded by unmeasured maternal factors. This study aims to examine the association between IPI and adverse perinatal outcomes using within-individual comparative analyses.

Methods: We studied 10,647 individuals from the National Institute of Child Health and Human Development Consecutive Pregnancies Study in Utah with ≥3 liveborn singleton pregnancies. We matched two IPIs per individual and used conditional logistic regression to examine the association between IPI and adverse perinatal outcomes, including preterm birth (PTB, <37 weeks' gestation), small-for-gestational-age (SGA, <10th percentile of sex-specific birthweight for gestational age), low birthweight (LBW, <2,500 g), and neonatal intensive care unit (NICU) admission. Point and 95% confidence interval (CI) estimates were adjusted for factors that vary across pregnancies within individuals.

Results: CIs did not unequivocally support either an increase or a decrease in the odds of PTB (adjusted odds ratio [aOR]: 1.31, 95% CI: 0.87, 1.96), SGA (aOR: 0.81, 95% CI: 0.51, 1.28), LBW (aOR: 1.59, 95% CI: 0.90, 2.80), or NICU admission (aOR: 0.96, 95% CI: 0.66, 1.40) for an IPI <6 months compared to 18-23-months IPI (reference), and neither did the CIs for the aOR of IPIs of 6-11 and 12-18 months compared to the reference. In contrast, an IPI ≥24 months was associated with increased odds of LBW (aOR: 1.66, 95% CI: 1.03, 2.66 for 24-29 months; aOR: 2.27, 95% CI: 1.21, 4.29 for 30-35 months; and aOR: 2.09, 95% CI: 1.17, 3.72 for ≥36 months).

Conclusions: Using a within-individual comparative method, we did not find evidence that a short IPI compared to the recommended IPI of 18-23 months was associated with increased odds of PTB, SGA, LBW, and NICU admission. IPI ≥ 24 months was associated with increased odds of delivering an LBW infant.

Keywords: adverse perinatal outcomes; birth spacing; interpregnancy interval; sibling comparison; within‐individual comparison; within‐woman comparison.

Abstract

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