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Racial Differences in the Influence of Interpregnancy Interval on Fetal Growth

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Abstract

Objectives Assess the influence of maternal race on the association between interpregnancy interval (IPI) and risk of small for gestational age (SGA) and large for gestational age (LGA) births. Methods Statewide population-based cohort study of 380,520 singleton births. We calculated risk of SGA and LGA births following IPIs of 0 to <6, 6 to <12, 12 to <24 (referent), 24 to <60 months, and ≥60 months, by maternal race after adjustment for confounding influences. Results The highest risk for SGA among white women followed short IPI of 0 to <6 months [adjRR 1.14 (95 % CI 1.08–1.21)], and long IPI ≥ 60 months [adjRR 1.37 (95 % CI 1.31–1.43)]. Only long IPI ≥ 60 months increased SGA risk in black women [adjRR 1.22 (95 % CI 1.13–1.32)]. LGA risk in white women was lowest with shortest and longest IPIs, 0 to <6 [adjRR 0.80 (95 % CI 0.76–0.84)] and ≥60 months [adjRR 0.68 (95 % CI 0.66–0.70)]. The crude risk of LGA was directly proportional to longer IPIs in black women. However, after adjusting for confounding effects of age, obesity, excessive gestational weight gain, and gestational diabetes, the effect was reversed to reduced risk following long IPI ≥ 60 months [adjRR 0.82 (95 % CI 0.74–0.91)], similar to that of white women. Conclusions In black and white women, an interpregnancy interval of 1–2 years is associated with optimal fetal growth. In addition to birth spacing, addressing modifiable factors such as pre-pregnancy BMI, monitoring gestational weight gain, and control of gestational diabetes in black women may help optimize fetal growth.

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Acknowledgments

This study includes data provided by the Ohio Department of Health, which should not be considered an endorsement of this study or its conclusions.

Funding

This work was supported by the Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA, and March of Dimes Grant 22-FY14-470 for the March of Dimes Prematurity Research Center Ohio, Collaborative, USA.

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Authors and Affiliations

  1. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Mihir R. Atreya, Louis J. Muglia & James M. Greenberg

  2. Division of Neonatology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Louis J. Muglia & James M. Greenberg

  3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, 231 Albert Sabin Way, MSB-4553B, Cincinnati, OH, 45267-0526, USA

    Louis J. Muglia & Emily A. DeFranco

  4. Center for Prevention of Preterm Birth, Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Louis J. Muglia, James M. Greenberg & Emily A. DeFranco

Authors
  1. Mihir R. Atreya
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  2. Louis J. Muglia
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  3. James M. Greenberg
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  4. Emily A. DeFranco
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Correspondence to Emily A. DeFranco.

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Additional information

Disclaimer: Access to de-identified Ohio birth certificate data was provided by the Ohio Department of Health. All of the analysis, interpretations, and conclusions that were derived from the data source and included in this article are those of the authors and not the Ohio Department of Health.

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Atreya, M.R., Muglia, L.J., Greenberg, J.M. et al. Racial Differences in the Influence of Interpregnancy Interval on Fetal Growth. Matern Child Health J 21, 562–570 (2017). https://doi.org/10.1007/s10995-016-2140-8

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  • DOI: https://doi.org/10.1007/s10995-016-2140-8

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