Document Detail


Interpregnancy interval and subsequent perinatal outcomes among women delaying initiation of childbearing.
MedLine Citation:
PMID:  19012690     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: While delayed initiation of childbearing is associated with adverse perinatal outcomes, whether or not risk persists and whether interpregnancy interval (IPI) affects the subsequent pregnancy remains unclear.
OBJECTIVES: To examine second-pregnancy perinatal outcomes for women initiating childbearing age > or = 30 compared to those initiating childbearing aged 20-29, specifically examining the distribution of adverse perinatal outcomes, and their associations with the interpregnancy interval.
METHODS: Retrospective cohort study using the Missouri maternally linked files 1978-1997. Perinatal outcomes included fetal death, low birthweight, preterm birth and small-for-gestational age. Predictor variables included maternal age at first pregnancy and IPI between the first and second pregnancy.
RESULTS: With an increasing maternal age at first pregnancy, rates of very low birthweight (P = 0.0095), preterm delivery (P = 0.0126), moderately preterm (P = 0.0458), and extremely preterm (P = 0.0008) in the second pregnancy increased, while the rate of small-for-gestational age (P < 0.0001) declined. Interpregnancy intervals <6 and > or = 60 months were associated with a higher rate of adverse outcomes after controlling for maternal age at first pregnancy. Intervals of 12-17 months had the lowest rate of adverse outcomes for mothers 35+. Maternal age > or = 35 years at first pregnancy and IPI <6 months were independent risk factors for an adverse outcome in the second pregnancy, however no statistical interaction between these factors was observed.
CONCLUSION: Delayed initiation of childbearing is associated with a persistent risk of adverse perinatal outcomes in the second pregnancy, with a short IPI contributing to this risk. As numbers of women delaying childbearing beyond age 30 increase, providers should consider these risks in counseling women about their reproductive plans.
Authors:
Sarah K Nabukera; Martha S Wingate; Russell S Kirby; John Owen; Shailender Swaminathan; Greg R Alexander; Hamisu M Salihu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  34     ISSN:  1341-8076     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-02-24     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  941-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Birth Intervals*
Cohort Studies
Female
Humans
Infant, Newborn
Maternal Age*
Middle Aged
Pregnancy
Pregnancy Outcome
Reproductive Behavior*
Retrospective Studies
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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