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Am J Perinatol 2023; 40(02): 201-205
DOI: 10.1055/s-0041-1728819
Original Article

Measuring Variation in Interpregnancy Interval: Identifying Hotspots for Improvement Initiatives

Scarlett D. Karakash
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
,
Elliott K. Main
2   California Maternal Quality Care Collaborative, Stanford University School of Medicine, Stanford, California
,
Shen Chih Chang
3   California Maternal Quality Care Collaborative, Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, California
,
Gary M. Shaw 
4   March of Dimes Prematurity Research Center at Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, California
,
David K. Stevenson
4   March of Dimes Prematurity Research Center at Stanford University School of Medicine and Lucile Packard Children's Hospital at Stanford, Stanford University School of Medicine, Stanford, California
,
Jeffrey B. Gould
5   California Perinatal Quality Care Collaborative, Stanford University School of Medicine, Stanford, California
› Author Affiliations Funding None.
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Abstract

Objective The study aimed to determine if single year birth certificate data can be used to identify regional and hospital variation in rates of short interpregnancy interval (IPI < 6 months).

Study Design IPI was estimated for multiparous women ages 15 to 44 years with singleton live births between 2015 and 2016. Perinatal outcomes, place of birth, maternal race, and data for IPI calculations were obtained by using birth certificates. IPI frequencies are presented as observed rates.

Results The cohort included 562,039 multiparous women. Short IPI rates were similar to those obtained with analyses by using linked longitudinal data and confirmed the association with preterm birth. Short IPI rates varied by race and Hispanic nativity. There was substantial hospital (0.8–9%) and regional (2.9–6.2%) variation in short IPI rates.

Conclusion IPI rates can be reliably obtained from current year birth certificate data. This can be a useful tool for quality improvement projects targeting interventions and rapidly assessing their progress to promote optimal birth spacing.

Key Points

  • Near-real time regional and hospital IPI rates can be reliably obtained from current year birth certificate data.

  • Substantial variations in rates of short IPI exist between hospital and perinatal regions.

  • IPI rates from individual birth certificates can be a tool to target and assess interventions.

Keywords

interpregnancy interval - preterm birth - quality improvement - maternal disparities


Publication History

Received: 20 May 2020

Accepted: 02 March 2021

Article published online:
03 May 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Birth spacing and risk of adverse perinatal outcomes: a meta-analysis. JAMA 2006; 295 (15) 1809-1823
    CrossrefPubMedGoogle Scholar
  • 2 Lonhart JA, Mayo JA, Padula AM, Wise PH, Stevenson DK, Shaw GM. Short interpregnancy interval as a risk factor for preterm birth in non-Hispanic Black and White women in California. J Perinatol 2019; 39 (09) 1175-1181
    CrossrefPubMedGoogle Scholar
  • 3 Shachar BZ, Mayo JA, Lyell DJ. et al. Interpregnancy interval after live birth or pregnancy termination and estimated risk of preterm birth: a retrospective cohort study. BJOG 2016; 123 (12) 2009-2017
    CrossrefPubMedGoogle Scholar
  • 4 Smith GC, Pell JP, Dobbie R. Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study. BMJ 2003; 327 (7410): 313
    CrossrefPubMedGoogle Scholar
  • 5 Chen I, Jhangri GS, Chandra S. Relationship between interpregnancy interval and congenital anomalies. Am J Obstet Gynecol 2014; 210 (06) 564.e1-564.e8
    CrossrefPubMedGoogle Scholar
  • 6 Conde-Agudelo A, Belizán JM. Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ 2000; 321 (7271): 1255-1259
    CrossrefPubMedGoogle Scholar
  • 7 McKinney D, House M, Chen A, Muglia L, DeFranco E. The influence of interpregnancy interval on infant mortality. Am J Obstet Gynecol 2017; 216 (03) 316.e1-316.e9
    CrossrefPubMedGoogle Scholar
  • 8 American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine. 8: Interpregnancy Care. Obstet Gynecol 2019; 133 (01) e51-e72
    CrossrefPubMedGoogle Scholar
  • 9 Klebanoff MA. Interpregnancy Interval and Pregnancy Outcomes: Causal or Not?. Obstet Gynecol 2017; 129 (03) 405-407
    CrossrefPubMedGoogle Scholar
  • 10 Office of Disease Prevention and Health Promotion. Healthy People 2020: Family Planning 2012. Accessed 2020 at: https://www.healthypeople.gov/2020/topics-objectives/topic/family-planning/objectives
    PubMedGoogle Scholar
  • 11 National Institutes of Health. Notice of special interest: research to improve pre-pregnancy care and enhance healthy birth intervals 2019, September 4. Accessed 2020 at: https://grants.nih.gov/grants/guide/notice-files/NOT-HD-19-019.html
    PubMedGoogle Scholar
  • 12 Gemmill A, Lindberg LD. Short interpregnancy intervals in the United States. Obstet Gynecol 2013; 122 (01) 64-71
    CrossrefPubMedGoogle Scholar
  • 13 Thoma ME, De Silva DA, MacDorman MF. Examining interpregnancy intervals and maternal and perinatal health outcomes using U.S. vital records: Important considerations for analysis and interpretation. Paediatr Perinat Epidemiol 2019; 33 (01) O60-O72
    CrossrefPubMedGoogle Scholar
  • 14 Copen CE, Thoma ME, Kirmeyer S. Interpregnancy intervals in the United States: data from the Birth Certificate and the National Survey of Family Growth. Natl Vital Stat Rep 2015; 64 (03) 1-10
    PubMedGoogle Scholar
  • 15 Martin JA, Osterman MJ, Kirmeyer SE, Gregory EC. Measuring gestational age in vital statistics data: transitioning to the obstetric estimate. Natl Vital Stat Rep 2015; 64 (05) 1-20
    PubMedGoogle Scholar