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Am J Perinatol 2017; 34(02): 174-182
DOI: 10.1055/s-0036-1584896
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

The Effect of Interpregnancy Interval on the Recurrence Rate of Spontaneous Preterm Birth: A Retrospective Cohort Study

Bouchra Koullali
1   Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands
,
Esme I. Kamphuis
1   Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands
2   Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands
,
Michel H.P. Hof
3   Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands
,
Sarah A. Robertson
4   The Robinson Research Institute, School of Medicine, University of Adelaide, The South Australian Health and Medical Research Institute Adelaide, Australia
,
Eva Pajkrt
1   Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands
,
Christianne J.M. de Groot
2   Department of Obstetrics and Gynecology, VU University Medical Centre, Amsterdam, The Netherlands
,
Ben W.J. Mol
4   The Robinson Research Institute, School of Medicine, University of Adelaide, The South Australian Health and Medical Research Institute Adelaide, Australia
,
Anita C.J. Ravelli
1   Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

29 January 2016

25 May 2016

Publication Date:
01 July 2016 (online)

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Abstract

Objective We assessed, in women with a previous spontaneous preterm birth, the effect of interpregnancy interval on the subsequent preterm birth rate.

Design Retrospective cohort study.

Setting A nationwide longitudinal dataset of the the Netherlands Perinatal Registry.

Population Women with three sequential singleton pregnancies between 1999 and 2009 and a spontaneous preterm birth <37 weeks in the first pregnancy.

Methods We evaluated the impact of interpregnancy interval on the course of the next pregnancies. Antenatal death and/or congenital abnormalities were excluded. Conventional and conditional logistic regression analysis were applied. We adjusted for maternal age, ethnicity, socioeconomic status, artificial reproductive techniques, and year of birth.

Main Outcome Measures Outcomes studied were preterm birth <37 weeks, <32 weeks, low birth weight <2500 g, and small for gestational age <10th percentile.

Results Among 2,361 women with preterm birth in the first pregnancy, logistic regression analysis indicated a significant effect of a short interpregnancy interval (0–5 mo) on recurrent preterm birth <37 weeks (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.62–3.05), <32 weeks (OR, 2.90; 95% CI, 1.43–5.87), and low birth weight (OR, 2.69; 95% CI, 1.79–4.03). In addition, a long interval (≥60 mo) had a significant effect on preterm birth <37 weeks (OR, 2.19; 95% CI, 1.29–3.74). Conditional logistic regression analysis confirmed the effect of a short interval on the recurrence of preterm birth rate <37 weeks and low birth weight.

Conclusion In women with a previous spontaneous preterm birth, a short interpregnancy interval has a strong impact on the risk of preterm birth before 37 weeks and low birth weight in the next pregnancy, irrespective of the type of analysis performed.

Keywords

interpregnancy interval - spontaneous - preterm birth - recurrence risk

Note

This study was presented orally at the 35th Annual Meeting, The Pregnancy Meeting, February 2 to 7, 2015, San Diego, California (Abstract # 16; out of 86 oral presentations).