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妊娠间隔与后续妊娠不良分娩结局风险之间的关联:一项来自约旦的回顾性研究。

Association between inter-pregnancy interval and risk of adverse birth outcomes in subsequent pregnancy: A retrospective study from Jordan.

作者信息

Hijazi Heba, Alameddine Mohamad, Al Abdi Rabah M, Baniissa Wegdan, Sindiani Amer, Al-Yateem Nabeel, Al-Sharman Alham, Al Marzouqi Alounoud, Hossain Ahmed

机构信息

Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.

Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Birth. 2023 Dec;50(4):946-958. doi: 10.1111/birt.12746. Epub 2023 Jul 16.

Abstract

BACKGROUND

Adverse birth outcomes, such as preterm birth and low birth weight (LBW), are leading causes of neonatal morbidity and mortality. In this study, we aimed to estimate the association between inter-pregnancy interval (IPI) and the risks of adverse birth outcomes in a subsequent pregnancy.

METHODS

We conducted a retrospective analysis involving 630 mothers who delivered a singleton live infant at a leading tertiary hospital in northern Jordan from March to August 2021. Outcome variables were preterm birth (<37 weeks of gestation) and LBW (<2.5 kg). Using multivariable logistic regression, the association between IPI and these two adverse birth outcomes was investigated.

RESULTS

The rates of preterm birth and LBW were 12.4% and 16.8%, respectively. Compared with an optimal IPI (24-36 months), a short IPI (<24 months) was positively associated with preterm birth (aOR: 4.09; 95% CI: 1.48-6.55) and LBW (aOR: 3.58; 95% CI: 1.57-5.15). Infants conceived after a long IPI (≥ 60 months) had increased odds of preterm birth (aOR: 3.78; 95% CI: 1.12-5.78) and LBW (aOR: 2.65; 95% CI: 1.67-4.03). Preterm delivery was also significantly associated with the mother's age (aOR: 1.10; 95% CI: 1.04-1.17), history of multiple cesarean births (aOR: 2.67; 95% CI: 1.14-4.29), prolonged rupture of membranes (aOR: 2.46; 95% CI: 1.10-5.52), and perinatal death (aOR: 3.42; 95% CI: 1.10-5.49). A mother's history of prior LBW (aOR: 4.39; 95% CI: 1.08-6.80), hypertensive disorders (aOR: 1.95; 95% CI: 1.03-3.89), and multiple cesarean births (aOR: 4.35; 95% CI: 2.10-6.99) was associated with LBW.

CONCLUSIONS

Both short and long IPIs were related to preterm delivery and LBW. Optimal birth spacing is recommended to improve birth outcomes and must be considered when designing effective family planning programs.

摘要

背景

不良分娩结局,如早产和低出生体重(LBW),是新生儿发病和死亡的主要原因。在本研究中,我们旨在评估妊娠间隔(IPI)与后续妊娠中不良分娩结局风险之间的关联。

方法

我们进行了一项回顾性分析,纳入了2021年3月至8月在约旦北部一家领先的三级医院分娩单胎活婴的630名母亲。结局变量为早产(妊娠<37周)和低出生体重(<2.5千克)。使用多变量逻辑回归分析,研究IPI与这两种不良分娩结局之间的关联。

结果

早产率和低出生体重率分别为12.4%和16.8%。与最佳IPI(24 - 36个月)相比,短IPI(<24个月)与早产(调整后比值比:4.09;95%置信区间:1.48 - 6.55)和低出生体重(调整后比值比:3.58;95%置信区间:1.57 - 5.15)呈正相关。长IPI(≥60个月)后受孕的婴儿早产(调整后比值比:3.78;95%置信区间:1.12 - 5.78)和低出生体重(调整后比值比:2.65;95%置信区间:1.67 - 4.03)的几率增加。早产还与母亲年龄(调整后比值比:1.10;95%置信区间:1.04 - 1.17)、多次剖宫产史(调整后比值比:2.67;95%置信区间:1.14 - 4.29)、胎膜早破(调整后比值比:2.46;95%置信区间:1.10 - 5.52)和围产期死亡(调整后比值比:3.42;95%置信区间:1.10 - 5.49)显著相关。母亲既往低出生体重史(调整后比值比:4.39;95%置信区间:1.08 - 6.80)、高血压疾病(调整后比值比:1.95;95%置信区间:1.03 - 3.89)和多次剖宫产史(调整后比值比:4.35;95%置信区间:2.10 - 6.99)与低出生体重相关。

结论

短IPI和长IPI均与早产和低出生体重有关。建议采用最佳生育间隔以改善分娩结局,在设计有效的计划生育项目时必须予以考虑。

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