Skip to main content

Long interpregnancy interval and adverse perinatal outcomes: A retrospective cohort study

Science China Life Sciences volume 63, pages 898–904 (2020)Cite this article

Abstract

We conducted a retrospective cohort study of 9,552 women experiencing their second delivery between 2014 and 2016 at the International Peace Maternity and Child Health Hospital to investigate the association between the interpregnancy interval (IPI) and adverse perinatal outcomes. With the 12–23-mon IPI as the reference category, logistic regression analyzes were used to examine associations between different IPIs (<12, 12–23, 24–59, 60–119, and ≥120 mon) and perinatal outcomes (gestational diabetes mellitus, premature membrane rupture, gestational hypertension, preterm birth, low birth weight, and macrosomia). Compared with the 12–23-mon IPI category, women with longer IPIs had a higher risk of adverse perinatal outcomes, and those with an IPI ≥120 mon had the highest risk of gestational diabetes mellitus and premature membrane rupture (adjusted odds ratio (OR) 1.76, 95% confidence interval (CI) 1.32–2.35 and adjusted OR 2.03, 95% CI 1.53–2.67, respectively). These results indicate that a longer IPI is associated with a higher risk of adverse perinatal outcomes and an IPI of ≥120 mon appears to be independently associated with a higher risk of gestational diabetes mellitus and premature membrane rupture.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

References

  • Al-Rowaily, M.A., and Abolfotouh, M.A. (2010). Predictors of gestational diabetes mellitus in a highparity community in Saudi Arabia. East Mediterr Health J 16, 636–641.

    CAS  Article  Google Scholar 

  • Bigelow, C.A., and Bryant, A.S. (2015). Short interpregnancy intervals: An evidence-based guide for clinicians. Obstetrical Gynecol Survey 70, 458–464.

    Article  Google Scholar 

  • Cecatti, J.G., Correa-Silva, E.P.B., Milanez, H., Morais, S.S., and Souza, J. P. (2008). The associations between inter-pregnancy interval and maternal and neonatal outcomes in Brazil. Matern Child Health J 12, 275–281.

    Article  Google Scholar 

  • Conde-Agudelo, A., and Belizán, J.M. (2000). Maternal morbidity and mortality associated with interpregnancy interval: Cross sectional study. BMJ 321, 1255–1259.

    CAS  Article  Google Scholar 

  • Conde-Agudelo, A., Belizán, J.M., Norton, M.H., and Rosas-Bermúdez, A. (2005). Effect of the interpregnancy interval on perinatal outcomes in Latin America. Obstetrics Gynecol 106, 359–366.

    Article  Google Scholar 

  • Conde-Agudelo, A., Rosas-Bermúdez, A., and Kafury-Goeta, A.C. (2006). Birth spacing and risk of adverse perinatal outcomes: A meta-analysis. JAMA 295, 1809–1823.

    CAS  Article  Google Scholar 

  • DeFranco, E.A., Seske, L.M., Greenberg, J.M., and Muglia, L.J. (2015). Influence of interpregnancy interval on neonatal morbidity. Am J Obstetrics Gynecol 212, 386.e1–386.e9.

    Article  Google Scholar 

  • Hafner, E., Schuchter, K., Metzenbauer, M., and Philipp, K. (2000). Uterine artery Doppler perfusion in the first and second pregnancies. Ultrasound Obstet Gynecol 16, 625–629.

    CAS  Article  Google Scholar 

  • Hanley, G.E., Hutcheon, J.A., Kinniburgh, B.A., and Lee, L. (2017). Interpregnancy interval and adverse pregnancy outcomes. Obstetrics Gynecol 129, 408–415.

    Article  Google Scholar 

  • Hesketh, T., Zhou, X., and Wang, Y. (2015). The end of the one-child policy: Lasting implications for China. JAMA 314, 2619–2620.

    CAS  Article  Google Scholar 

  • Kangatharan, C., Labram, S., and Bhattacharya, S. (2016). Interpregnancy interval following miscarriage and adverse pregnancy outcomes: Systematic review and meta-analysis. Hum Reprod Update 18, 221–231.

    Google Scholar 

  • Mignini, L.E., Carroli, G., Betran, A.P., Fescina, R., Cuesta, C., Campodonico, L., De Mucio, B., and Khan, K.S. (2016). Interpregnancy interval and perinatal outcomes across Latin America from 1990 to 2009: A large multi-country study. BJOG-Int J Obstet Gy 123, 730–737.

    CAS  Article  Google Scholar 

  • Mittendorf, R., Lain, K.Y., Williams, M.A., and Walker, C.K. (1996). Preeclampsia: A nested, case-control study of risk factors and their interactions. J Reprod Med, 41, 491–496.

    CAS  PubMed  Google Scholar 

  • Qin, C., Mi, C., Xia, A., Chen, W.T., Chen, C., Li, Y., Li, Y., Bai, W., and Tang, S. (2017). A first look at the effects of long inter-pregnancy interval and advanced maternal age on perinatal outcomes: A retrospective cohort study. Birth 44, 230–237.

    Article  Google Scholar 

  • Shachar, B.Z., Mayo, J.A., Lyell, D.J., Baer, R.J., Jeliffe-Pawlowski, L.L., Stevenson, D.K., and Shaw, G.M. (2016). Interpregnancy interval after live birth or pregnancy termination and estimated risk of preterm birth: A retrospective cohort study. BJOG-Int J Obstet Gy 123, 2009–2017.

    CAS  Article  Google Scholar 

  • Shah, P.S. (2010). Parity and low birth weight and preterm birth: A systematic review and meta-analyses. Acta Obstet Gynecol Scand 89, 862–875.

    Article  Google Scholar 

  • Sholapurkar, S.L. (2010). Is there an ideal interpregnancy interval after a live birth, miscarriage or other adverse pregnancy outcomes? J Obstetrics Gynaecol 30, 107–110.

    CAS  Article  Google Scholar 

  • Shults, R.A., Arndt, V., Olshan, A.F., Martin, C.F., and Royce, R.A. (1999). Effects of short interpregnancy intervals on small-for-gestational age and preterm births. Epidemiology 10, 250–254.

    CAS  Article  Google Scholar 

  • Stamilio, D.M., DeFranco, E., Paré, E., Odibo, A.O., Peipert, J.F., Allsworth, J.E., Stevens, E., and Macones, G.A. (2007). Short interpregnancy interval: Risk of uterine rupture and complications of vaginal birth after cesarean delivery. Obstetrics Gynecol 110, 1075–1082.

    Article  Google Scholar 

  • Waldenström, U., Cnattingius, S., Norman, M., and Schytt, E. (2015). Advanced maternal age and stillbirth risk in nulliparous and parous women. Obstetrics Gynecol 126, 355–362.

    Article  Google Scholar 

  • Wang, C. (2012). History of the Chinese Family Planning program: 1970–2010. Contraception 85, 563–569.

    Article  Google Scholar 

  • Wendt, A., Gibbs, C.M., Peters, S., and Hogue, C.J. (2012). Impact of increasing inter-pregnancy interval on maternal and infant health. Paediatric Perinatal Epidemiol 26, 239–258.

    Article  Google Scholar 

  • Zeng, Y., and Hesketh, T. (2016). The effects of China’s universal two-child policy. Lancet 388, 1930–1938.

    Article  Google Scholar 

  • Zhu, B.P., Rolfs, R.T., Nangle, B.E., and Horan, J.M. (1999). Effect of the interval between pregnancies on perinatal outcomes. N Engl J Med 340, 589–594.

    CAS  Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the Major Program of National Natural Science Foundation of China (81490742, 31471405, 81771593 and 81671456), the National Key Research and Development Program of China (2017YFC1001303 and 2018YFC1003200), the International Cooperation Project of China and Canada NSFC (81661128010), the Interdisciplinary Key Program of Shanghai Jiao Tong University (YG2014ZD08), and the Shen Kang Three-Year Action Plan (16CR3003A).

Author information

Author notes

  1. Contributed equally to this work.

Affiliations

  1. International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China

    Jing Lin, Han Liu, Dan-Dan Wu, Hong-Tao Hu, Hui-Hui Wang, Cheng-Liang Zhou, Xin-Mei Liu, Xiao-Jun Chen & He-Feng Huang

  2. Institute of Embryo-Fetal Original Adult Disease, Shanghai Key Laboratory for Reproductive Medicine, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200030, China

    Jing Lin, Han Liu, Dan-Dan Wu, Hong-Tao Hu, Hui-Hui Wang, Cheng-Liang Zhou, Xin-Mei Liu & He-Feng Huang

  3. Shanghai Key Laboratory of Embryo Original Disease, Shanghai, 200030, China

    Jing Lin, Han Liu, Dan-Dan Wu, Hong-Tao Hu, Hui-Hui Wang, Cheng-Liang Zhou, Xin-Mei Liu & He-Feng Huang

  4. Department of Pathology and Pathophysiology, School of Medicine, Zhejiang University, Hangzhou, 310058, China

    Jian-Zhong Sheng

Authors
  1. Jing Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Han Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dan-Dan Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hong-Tao Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hui-Hui Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cheng-Liang Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xin-Mei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xiao-Jun Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Jian-Zhong Sheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. He-Feng Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to He-Feng Huang.

Ethics declarations

Compliance and ethics The author(s) declare that they have no conflict of interest. The study was approved by the Ethics Committee of the International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University. Written informed consent was obtained from all participants.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lin, J., Liu, H., Wu, DD. et al. Long interpregnancy interval and adverse perinatal outcomes: A retrospective cohort study. Sci. China Life Sci. 63, 898–904 (2020). https://doi.org/10.1007/s11427-018-9593-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11427-018-9593-8

Keywords

  • interpregnancy interval
  • perinatal outcomes
  • gestational diabetes mellitus
  • premature membrane rupture