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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).


 

  • References

  • 1 Ananth CV, Vintzileos AM. Epidemiology of preterm birth and its clinical subtypes. J Matern Fetal Neonatal Med 2006; 19 (12) 773-782
    CrossrefPubMedGoogle Scholar
  • 2 Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet 2008; 371 (9608) 261-269
    CrossrefPubMedGoogle Scholar
  • 3 Schaaf JM, Mol BW, Abu-Hanna A, Ravelli AC. Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007. BJOG 2011; 118 (10) 1196-1204
    CrossrefPubMedGoogle Scholar
  • 4 Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008; 371 (9606) 75-84
    CrossrefPubMedGoogle Scholar
  • 5 Esplin MS, O'Brien E, Fraser A , et al. Estimating recurrence of spontaneous preterm delivery. Obstet Gynecol 2008; 112 (3) 516-523
    CrossrefPubMedGoogle Scholar
  • 6 Zhu BP, Rolfs RT, Nangle BE, Horan JM. Effect of the interval between pregnancies on perinatal outcomes. N Engl J Med 1999; 340 (8) 589-594
    CrossrefPubMedGoogle Scholar
  • 7 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
  • 8 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
  • 9 World Health Organization. Report of a WHO Technical Consultation on Birth Spacing. World Health Organization; 2005: 1-34
    Google Scholar
  • 10 Klebanoff MA. The interval between pregnancies and the outcome of subsequent births. N Engl J Med 1999; 340 (8) 643-644
    CrossrefPubMedGoogle Scholar
  • 11 Ball SJ, Pereira G, Jacoby P, de Klerk N, Stanley FJ. Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother. BMJ 2014; 349: g4333 DOI: 10.1136/bmj.g4333.
    CrossrefPubMedGoogle Scholar
  • 12 Méray N, Reitsma JB, Ravelli AC, Bonsel GJ. Probabilistic record linkage is a valid and transparent tool to combine databases without a patient identification number. J Clin Epidemiol 2007; 60 (9) 883-891
    PubMedGoogle Scholar
  • 13 Tromp M, Ravelli AC, Méray N, Reitsma JB, Bonsel GJ. An efficient validation method of probabilistic record linkage including readmissions and twins. Methods Inf Med 2008; 47 (4) 356-363
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Schaaf JM, Hof MH, Mol BW, Abu-Hanna A, Ravelli AC. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery. BJOG 2012; 119 (13) 1624-1629
    CrossrefPubMedGoogle Scholar
  • 15 Schaaf JM, Hof MH, Mol BW, Abu-Hanna A, Ravelli AC. Recurrence risk of preterm birth in subsequent singleton pregnancy after preterm twin delivery. Am J Obstet Gynecol 2012; 207 (4) 279.e1-279.e7
    CrossrefPubMedGoogle Scholar
  • 16 DeFranco EA, Stamilio DM, Boslaugh SE, Gross GA, Muglia LJ. A short interpregnancy interval is a risk factor for preterm birth and its recurrence. Am J Obstet Gynecol 2007; 197 (3) 264.e1-264.e6
    CrossrefPubMedGoogle Scholar
  • 17 Zhu BP. Effect of interpregnancy interval on birth outcomes: findings from three recent US studies. Int J Gynaecol Obstet 2005; 89 (Suppl. 01) S25-S33
    CrossrefPubMedGoogle Scholar
  • 18 Conde-Agudelo A, Rosas-Bermúdez A, Kafury-Goeta AC. Effects of birth spacing on maternal health: a systematic review. Am J Obstet Gynecol 2007; 196 (4) 297-308
    CrossrefPubMedGoogle Scholar
  • 19 Grisaru-Granovsky S, Gordon ES, Haklai Z, Samueloff A, Schimmel MM. Effect of interpregnancy interval on adverse perinatal outcomes—a national study. Contraception 2009; 80 (6) 512-518
    CrossrefPubMedGoogle Scholar
  • 20 Romero R, Dey SK, Fisher SJ. Preterm labor: one syndrome, many causes. Science 2014; 345 (6198) 760-765
    CrossrefPubMedGoogle Scholar
  • 21 Kim CJ, Romero R, Chaemsaithong P, Kim JS. Chronic inflammation of the placenta: definition, classification, pathogenesis, and clinical significance. Am J Obstet Gynecol 2015; 213 (4, Suppl) S53-S69
    CrossrefPubMedGoogle Scholar
  • 22 Parker SE, Werler MM. Epidemiology of ischemic placental disease: a focus on preterm gestations. Semin Perinatol 2014; 38 (3) 133-138
    CrossrefPubMedGoogle Scholar
  • 23 Rowe JH, Ertelt JM, Xin L, Way SS. Pregnancy imprints regulatory memory that sustains anergy to fetal antigen. Nature 2012; 490 (7418) 102-106
    CrossrefPubMedGoogle Scholar
  • 24 van Kampen CA, Versteeg-vd Voort Maarschalk MF, Langerak-Langerak J, Roelen DL, Claas FH. Kinetics of the pregnancy-induced humoral and cellular immune response against the paternal HLA class I antigens of the child. Hum Immunol 2002; 63 (6) 452-458
    CrossrefPubMedGoogle Scholar
  • 25 Guerin LR, Prins JR, Robertson SA. Regulatory T-cells and immune tolerance in pregnancy: a new target for infertility treatment?. Hum Reprod Update 2009; 15 (5) 517-535
    CrossrefPubMedGoogle Scholar
  • 26 Schober L, Radnai D, Schmitt E, Mahnke K, Sohn C, Steinborn A. Term and preterm labor: decreased suppressive activity and changes in composition of the regulatory T-cell pool. Immunol Cell Biol 2012; 90 (10) 935-944
    CrossrefPubMedGoogle Scholar