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

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 wi...

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Main Authors: Maria Sevoyan, Marco Geraci, Edward A. Frongillo, Jihong Liu, Nansi S. Boghossian
Format: Article
Language:English
Published: Wiley 2024-08-01
Series:Health Science Reports
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Online Access:https://doi.org/10.1002/hsr2.2313
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author Maria Sevoyan
Marco Geraci
Edward A. Frongillo
Jihong Liu
Nansi S. Boghossian
author_facet Maria Sevoyan
Marco Geraci
Edward A. Frongillo
Jihong Liu
Nansi S. Boghossian
author_sort Maria Sevoyan
collection DOAJ
description 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.
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spelling doaj-art-ef5a1ec7bd4d45c9ade3e06c9bba2f742025-08-20T03:44:03ZengWileyHealth Science Reports2398-88352024-08-0178n/an/a10.1002/hsr2.2313Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative methodMaria Sevoyan0Marco Geraci1Edward A. Frongillo2Jihong Liu3Nansi S. Boghossian4Department of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia South Carolina USADepartment of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia South Carolina USADepartment of Health Promotion, Education, and Behavior Arnold School of Public Health, University of South Carolina Columbia South Carolina USADepartment of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia South Carolina USADepartment of Epidemiology and Biostatistics Arnold School of Public Health, University of South Carolina Columbia South Carolina USAAbstract 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.https://doi.org/10.1002/hsr2.2313adverse perinatal outcomesbirth spacinginterpregnancy intervalsibling comparisonwithin‐individual comparisonwithin‐woman comparison
spellingShingle Maria Sevoyan
Marco Geraci
Edward A. Frongillo
Jihong Liu
Nansi S. Boghossian
Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative method
Health Science Reports
adverse perinatal outcomes
birth spacing
interpregnancy interval
sibling comparison
within‐individual comparison
within‐woman comparison
title Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative method
title_full Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative method
title_fullStr Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative method
title_full_unstemmed Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative method
title_short Interpregnancy interval and adverse perinatal outcomes: A within‐individual comparative method
title_sort interpregnancy interval and adverse perinatal outcomes a within individual comparative method
topic adverse perinatal outcomes
birth spacing
interpregnancy interval
sibling comparison
within‐individual comparison
within‐woman comparison
url https://doi.org/10.1002/hsr2.2313
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AT edwardafrongillo interpregnancyintervalandadverseperinataloutcomesawithinindividualcomparativemethod
AT jihongliu interpregnancyintervalandadverseperinataloutcomesawithinindividualcomparativemethod
AT nansisboghossian interpregnancyintervalandadverseperinataloutcomesawithinindividualcomparativemethod