Marinovich, ML; Regan, AK; Gissler, M; Magnus, MC; Håberg, SE; Mayo, JA; Shaw, GM; Bell, J; Nassar, N; Ball, S; +6 more... Gebremedhin, AT; Marston, C; de Klerk, N; Betrán, AP; Padula, AM; Pereira, G; (2020) Associations between interpregnancy interval and preterm birth by previous preterm birth status in four high-income countries: a cohort study. BJOG: AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 128 (7). pp. 1134-1143. ISSN 1470-0328 DOI: https://doi.org/10.1111/1471-0528.16606
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
OBJECTIVE: To investigate the effect of interpregnancy interval (IPI) on preterm birth (PTB) according to whether the previous birth was preterm or term. DESIGN: Cohort study. SETTING: USA (California), Australia, Finland, Norway (1980-2017). POPULATION: Women who gave birth to first and second (n = 3 213 855) singleton livebirths. METHODS: Odds ratios (ORs) for PTB according to IPIs were modelled using logistic regression with prognostic score stratification for potential confounders. Within-site ORs were pooled by random effects meta-analysis. OUTCOME MEASURE: PTB (gestational age <37 weeks). RESULTS: Absolute risk of PTB for each IPI was 3-6% after a previous term birth and 17-22% after previous PTB. ORs for PTB differed between previous term and preterm births in all countries (P-for-interaction ≤ 0.001). For women with a previous term birth, pooled ORs were increased for IPI <6 months (OR 1.50, 95% CI 1.43-1.58); 6-11 months (OR 1.10, 95% CI 1.04-1.16); 24-59 months (OR 1.16, 95% CI 1.13-1.18); and ≥ 60 months (OR 1.72, 95%CI 1.60-1.86), compared with 18-23 months. For previous PTB, ORs were increased for <6 months (OR 1.30, 95% CI 1.18-1.42) and ≥60 months (OR 1.29, 95% CI 1.17-1.42), but were less than ORs among women with a previous term birth (P < 0.05). CONCLUSIONS: Associations between IPI and PTB are modified by whether or not the previous pregnancy was preterm. ORs for short and long IPIs were higher among women with a previous term birth than a previous PTB, which for short IPI is consistent with the maternal depletion hypothesis. Given the high risk of recurrence and assuming a causal association between IPI and PTB, IPI remains a potentially modifiable risk factor for women with previous PTB. TWEETABLE ABSTRACT: Short versus long interpregnancy intervals associated with higher ORs for preterm birth (PTB) after a previous PTB.
Item Type | Article |
---|---|
Faculty and Department | Faculty of Public Health and Policy > Public Health, Environments and Society |
Research Centre | Centre for Maternal, Reproductive and Child Health (MARCH) |
PubMed ID | 33232573 |
Elements ID | 154280 |
Downloads
Filename: Marinovich_etal_2020_Associations-between-interpregnancy-interval-and.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
DownloadFilename: Marinovich_etal_2020_Associations-between-interpregnancy-interval-figure1.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
DownloadFilename: Marinovich_etal_2020_Associations-between-interpregnancy-interval-figure2.pdf
Licence: Creative Commons: Attribution-Noncommercial-No Derivative Works 3.0
Download