Effect of interpregnancy interval on adverse pregnancy outcomes in northern Tanzania: a registry-based retrospective cohort study

Michael J Mahande,Joseph Obure

doi:10.1186/s12884-016-0929-5

Abstract

BackgroundBoth short and long interpregnancy intervals have been associated with an increased risk of adverse pregnancy outcomes. There is limited information about the impact of interpregnancy interval on pregnancy (IPI) outcomes in Tanzania. The objective of this study was to assess the effect of IPI on adverse pregnancy outcomes.MethodsWe performed a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) birth registry. A total of 17,030 singlet births from women who delivered singleton infant at KCMC from 2000 to 2010 were studied. Women with multi-fetal gestations and those who were referred from rural areas for various medical reasons were excluded. Outcome variables were preterm birth, low birth weight infants and perinatal death. A multiple logistic regression was used to assess the association between IPI and pregnancy outcomes.ResultsThe median IPI was 36 months. Compared with IPIs of 24–36 months (referent group), short interpregnancy intervals (<24 months) was associated with preterm delivery (OR 1 · 52; 95 % CI 1.31–1.74); low birth weight (OR 1 · 61; 95 % CI 1 · 34–1.72) and perinatal death, (OR 1 · 63; 95 % CI 1.22–1.91). The IPI of 37–59 months or longer were also associated with higher risks of preterm birth and low birth weight, but not with perinatal death.ConclusionsOur study confirmed that both short and long IPI are independent risk factors for adverse pregnancy outcomes. These finding emphasize the importance of providing support for family planning programs which will support optimal IPI and improve pregnancy outcomes.

Highlights

Both short and long interpregnancy intervals have been associated with an increased risk of adverse pregnancy outcomes
Rates of adverse pregnancy outcomes in relation to interpregnancy interval on pregnancy (IPI) Overall, both short and long IPI were associated with increased rates of preterm birth and low birth weight
Compared with the reference group, short IPI was associated with high rates of preterm birth (10.51 % vs.12.57 %), low birth weight (8.5 % vs.11.97 %), and perinatal death (2.92 % vs. 4.14 %) whereas longer IPI was associated with high rates preterm birth (10.16 %), and low birth weight infants (8.64 %)

Summary

Introduction

Both short and long interpregnancy intervals have been associated with an increased risk of adverse pregnancy outcomes. Timed pregnancies increase health risks for both mother and infant while optimal interpregnancy interval (IPI) is an important determinant of maternal health and pregnancy outcomes [1, 2]. Previous studies in low and high income countries have shown that both short and long IPIs are associated with adverse maternal, perinatal and infant outcomes [1,2,3]. On the Mahande and Obure BMC Pregnancy and Childbirth (2016) 16:140 other hand, long IPI has been associated with increased risks of preterm birth, low birth weight, labour dystocia, preeclampsia and eclampsia [1, 15]

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