Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy
Abstract Background Since the implementation of China’s comprehensive two-child policy, the prevalence of long interpregnancy intervals (IPI) and advanced maternal age has increased. However, previous studies in China have mostly focused on the relationship between short IPIs and adverse perinatal o...
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BMC
2025-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-025-07136-8 |
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| author | SiQin Xiu Li Tang Chengjie Qin Di Tian Yuhong Chen Lingling Gu Liu Yang Yuhao Sun Xinghui Liu Yonghong Lin Yumei Wang |
| author_facet | SiQin Xiu Li Tang Chengjie Qin Di Tian Yuhong Chen Lingling Gu Liu Yang Yuhao Sun Xinghui Liu Yonghong Lin Yumei Wang |
| author_sort | SiQin Xiu |
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| description | Abstract Background Since the implementation of China’s comprehensive two-child policy, the prevalence of long interpregnancy intervals (IPI) and advanced maternal age has increased. However, previous studies in China have mostly focused on the relationship between short IPIs and adverse perinatal outcomes, while neglecting maternal age as a potential confounder. Methods We conducted a retrospective cohort study of 23,899 pregnant women who delivered between January 1, 2017 and December 31, 2019 at Chengdu Women’s and Children’s Central Hospital and West China Second Hospital of Sichuan University. IPIs were categorized as < 18 months, 18–23 months, 24–59 months, 60–119 months, and ≥ 120 months. Their relationships with clinical characteristics and pregnancy outcomes were analyzed using chi-square tests and Cochran-Armitage test for trend. Logistic regression modeling, incorporating restricted cubic spline (RCS), was used to assess association between IPI and adverse perinatal outcomes, including full-term low birthweight (LBW), preterm birth (PTB), small-for-gestational age (SGA) and adverse neonatal composite (very low birthweight, very preterm birth, severe neonatal asphyxia or death). Results Women with longer IPIs (≥ 120 months) were more likely to be older (≥ 35 years) and had higher rates of gestational diabetes and hypertensive disorders of pregnancy (p < 0.05). Compared to an IPI of 24–59 months, the risk of PTB was significantly higher with an IPI of ≥ 120 months for women aged ≥ 35 years (aOR,1.17; 95% CI, 0.89–1.55) and 30–34 years (aOR 2.17; 95% CI, 1.59–2.92), but not for those aged ≤ 29 years (aOR 1.34; 95% CI, 0.20–5.31). The risk of SGA increased with an IPI of ≥ 120 months for women aged 30–34 years (aOR, 2.19; 95% CI, 0.97–4.53) and with an IPI of 60–119 months for women aged ≤ 29 years (aOR,3.16; 95% CI, 1.62–6.30). Full-term LBW risk was elevated among women aged ≤ 29 years with an IPI of ≥ 120 months (aOR, 10.42; 95% CI, 0.55–59.52). However, there were no significant differences in the risk of adverse neonatal composite across different IPI groups with each age category (p > 0.05). Conclusion A long IPI increased the risk of SGA, full-term LBW and PTB, regardless of maternal age. Medical professionals should advise women an optimal IPI to mitigate these risks. With China’s shift from a “one-child” to a “three-child” policy, future research will focus on analyzing this new fertility pattern to refine IPI recommendations. |
| format | Article |
| id | doaj-art-32eaa1aa59ad4cf58e5817b4d4b83a79 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-32eaa1aa59ad4cf58e5817b4d4b83a792025-02-02T12:46:51ZengBMCBMC Pregnancy and Childbirth1471-23932025-01-0125111510.1186/s12884-025-07136-8Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policySiQin Xiu0Li Tang1Chengjie Qin2Di Tian3Yuhong Chen4Lingling Gu5Liu Yang6Yuhao Sun7Xinghui Liu8Yonghong Lin9Yumei Wang10Department of Gynecology and Obstetrics, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Gastroenterology, Shanghai East Hospital, School of Medicine, Tongji UniversityDepartment of Obstetrics and Gynecology, West China Second University Hospital, Sichuan UniversityDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Health Care, School of Medicine, Chengdu Women’s and Children’s Central Hospital, University of Electronic Science and Technology of ChinaAbstract Background Since the implementation of China’s comprehensive two-child policy, the prevalence of long interpregnancy intervals (IPI) and advanced maternal age has increased. However, previous studies in China have mostly focused on the relationship between short IPIs and adverse perinatal outcomes, while neglecting maternal age as a potential confounder. Methods We conducted a retrospective cohort study of 23,899 pregnant women who delivered between January 1, 2017 and December 31, 2019 at Chengdu Women’s and Children’s Central Hospital and West China Second Hospital of Sichuan University. IPIs were categorized as < 18 months, 18–23 months, 24–59 months, 60–119 months, and ≥ 120 months. Their relationships with clinical characteristics and pregnancy outcomes were analyzed using chi-square tests and Cochran-Armitage test for trend. Logistic regression modeling, incorporating restricted cubic spline (RCS), was used to assess association between IPI and adverse perinatal outcomes, including full-term low birthweight (LBW), preterm birth (PTB), small-for-gestational age (SGA) and adverse neonatal composite (very low birthweight, very preterm birth, severe neonatal asphyxia or death). Results Women with longer IPIs (≥ 120 months) were more likely to be older (≥ 35 years) and had higher rates of gestational diabetes and hypertensive disorders of pregnancy (p < 0.05). Compared to an IPI of 24–59 months, the risk of PTB was significantly higher with an IPI of ≥ 120 months for women aged ≥ 35 years (aOR,1.17; 95% CI, 0.89–1.55) and 30–34 years (aOR 2.17; 95% CI, 1.59–2.92), but not for those aged ≤ 29 years (aOR 1.34; 95% CI, 0.20–5.31). The risk of SGA increased with an IPI of ≥ 120 months for women aged 30–34 years (aOR, 2.19; 95% CI, 0.97–4.53) and with an IPI of 60–119 months for women aged ≤ 29 years (aOR,3.16; 95% CI, 1.62–6.30). Full-term LBW risk was elevated among women aged ≤ 29 years with an IPI of ≥ 120 months (aOR, 10.42; 95% CI, 0.55–59.52). However, there were no significant differences in the risk of adverse neonatal composite across different IPI groups with each age category (p > 0.05). Conclusion A long IPI increased the risk of SGA, full-term LBW and PTB, regardless of maternal age. Medical professionals should advise women an optimal IPI to mitigate these risks. With China’s shift from a “one-child” to a “three-child” policy, future research will focus on analyzing this new fertility pattern to refine IPI recommendations.https://doi.org/10.1186/s12884-025-07136-8Interpregnancy intervalAdverse pregnancy outcomesMaternal ageSmall for gestational ageLow birth weightPreterm birth |
| spellingShingle | SiQin Xiu Li Tang Chengjie Qin Di Tian Yuhong Chen Lingling Gu Liu Yang Yuhao Sun Xinghui Liu Yonghong Lin Yumei Wang Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy BMC Pregnancy and Childbirth Interpregnancy interval Adverse pregnancy outcomes Maternal age Small for gestational age Low birth weight Preterm birth |
| title | Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy |
| title_full | Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy |
| title_fullStr | Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy |
| title_full_unstemmed | Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy |
| title_short | Association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of China’s two-child policy |
| title_sort | association between interpregnancy interval and adverse perinatal outcomes according to maternal age in the context of china s two child policy |
| topic | Interpregnancy interval Adverse pregnancy outcomes Maternal age Small for gestational age Low birth weight Preterm birth |
| url | https://doi.org/10.1186/s12884-025-07136-8 |
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