Risk for short interpregnancy intervals among African-born black women in Washington State

Abstract

Objectives: We aimed to determine risk and associated risk factors for short interpregnancy intervals among African-born Black women in Washington State. Methods: We conducted a retrospective cohort study using vital statistics from linked birth certificate and hospital discharge records for 18,984 consecutive, singleton birth pairs to African-born Black (n=3312), US-born White (n=7839) and US-born Black women (n=7833) in Washington State from 1992 to 2013. We performed logistic regression to assess the association between mother's country of birth and race with interpregnancy interval and to assess risk factors for a short interval. Results: Women with short interpregnancy intervals comprised 10% of African-born women, 4.3% of US-born White women and 6.8% of US-born Black women. African-born women had higher odds of short intervals than US-born White women (aOR, 3.44; 95% CI, 2.53–4.68) or US born Black women (aOR, 1.49; 95% CI, 1.28–1.74). Among African-born women at the time of the first birth, women from East Africa (aOR, 3.51; 95% CI, 2.20–5.63), those who had high school or less education (aOR,1.92; 95% CI, 1.41–2.61), those who were nulliparous (aOR, 1.37; 95% CI, 1.01–1.86) and those who delivered vaginally for their first live birth (aOR,1.78; 95% CI, 1.29–2.44) in the first live birth of each birth pair had higher risk for short interpregnancy intervals Conclusions: African-born Black women are at higher risk for short interpregnancy intervals than US-born White and Black women in Washington State. Efforts are needed to increase prenatal counseling and education, including contraceptive information provision, for African-born women, who may face increased risks for adverse neonatal and maternal morbidity linked to short interpregnancy intervals.