Birth Spacing and Risk of Adverse Perinatal Outcomes

A Meta-analysis

Bibliographic Data

ID23348526
AuthorsAgustin Conde-Agudelo (Fundación Santa Fe de Bogotá), Anyeli Rosas-Bermúdez, Ana Cecilia Kafury-Goeta
Year2006
Volume295
Issue15
Pages1809
Publication date2006-04-19
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJAMA (JOURNAL)
Journal identifiersISSN: 0098-7484 • E-ISSN: 1538-3598
PublisherAmerican Medical Association (AMA) (PUBLISHER)
DOI10.1001/jama.295.15.1809
PMID16622143
OpenAlexW2068027757
LanguageEN
Citations received181
References cited17

CONTEXT: Both short and long interpregnancy intervals have been associated with an increased risk of adverse perinatal outcomes. However, whether this possible association is confounded by maternal characteristics or socioeconomic status is uncertain. OBJECTIVE: To examine the association between birth spacing and relative risk of adverse perinatal outcomes. DATA SOURCES: Studies published in any language were retrieved by searching MEDLINE (1966 through January 2006), EMBASE, ECLA, POPLINE, CINAHL, and LILACS, proceedings of meetings on birth spacing, and bibliographies of retrieved articles, and by contact with relevant researchers in the field. STUDY SELECTION: Included studies were cohort, cross-sectional, and case-control studies with results adjusted for at least maternal age and socioeconomic status, reporting risk estimates and 95% confidence intervals (or data to calculate them) of birth spacing and perinatal outcomes. Of 130 articles identified in the search, 67 (52%) were included. DATA EXTRACTION: Information on study design, participant characteristics, measure of birth spacing used, measures of outcome, control for potential confounding factors, and risk estimates was abstracted independently by 2 investigators using a standardized protocol. DATA SYNTHESIS: A random-effects model and meta-regression analyses were used to pool data from individual studies. Compared with interpregnancy intervals of 18 to 23 months, interpregnancy intervals shorter than 6 months were associated with increased risks of preterm birth, low birth weight, and small for gestational age (pooled adjusted odds ratios [95% confidence intervals]: 1.40 [1.24-1.58], 1.61 [1.39-1.86], and 1.26 [1.18-1.33], respectively). Intervals of 6 to 17 months and longer than 59 months were also associated with a significantly greater risk for the 3 adverse perinatal outcomes. CONCLUSIONS: Interpregnancy intervals shorter than 18 months and longer than 59 months are significantly associated with increased risk of adverse perinatal outcomes. These data suggest that spacing pregnancies appropriately could help prevent such adverse perinatal outcomes.

Birth weight · CINAHL · Cohort study · Confidence interval · Confounding · Environmental health · Gestational age · Low birth weight · Multiple birth · Obstetrics · Odds ratio · Population · Pregnancy · Premature birth · Psychological intervention · Socioeconomic status · Demography · Gestational Diabetes Research and Management · Internal Medicine · Medicine · Pregnancy and preeclampsia studies · Reproductive Health and Contraception · Pediatrics