1. Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population.
- Author
-
Congdon, Jayme L., Baer, Rebecca J., Arcara, Jennet, Feuer, Sky K., Gómez, Anu Manchikanti, Karasek, Deborah, Oltman, Scott P., Pantell, Matthew S., Ryckman, Kelli, and Jelliffe-Pawlowski, Laura
- Subjects
- *
FAMILY planning , *PREMATURE infants , *BIRTH intervals , *RETROSPECTIVE studies , *PREGNANCY outcomes , *SOCIOECONOMIC factors , *LOGISTIC regression analysis , *ODDS ratio , *SMALL for gestational age - Abstract
Introduction: Previous studies that used traditional multivariable and sibling matched analyses to investigate interpregnancy interval (IPI) and birth outcomes have reached mixed conclusions about a minimum recommended IPI, raising concerns about confounding. Our objective was to isolate the contribution of interpregnancy interval to the risk for adverse birth outcomes using propensity score matching. Methods: For this retrospective cohort study, data were drawn from a California Department of Health Care Access and Information database with linked vital records and hospital discharge records (2007–2012). We compared short IPIs of < 6, 6–11, and 12–17 months to a referent IPI of 18–23 months using 1:1 exact propensity score matching on 13 maternal sociodemographic and clinical factors. We used logistic regression to calculate the odds of preterm birth, early-term birth, and small for gestational age (SGA). Results: Of 144,733 women, 73.6% had IPIs < 18 months, 5.5% delivered preterm, 27.0% delivered early-term, and 6.0% had SGA infants. In the propensity matched sample (n = 83,788), odds of preterm birth were increased among women with IPI < 6 and 6–11 months (OR 1.89, 95% CI 1.71–2.0; OR 1.22, 95% CI 1.13–1.31, respectively) and not with IPI 12–17 months (OR 1.01, 95% CI 0.94–1.09); a similar pattern emerged for early-term birth. The odds of SGA were slightly elevated only for intervals < 6 months (OR 1.10, 95% CI 1.00–1.20, p <.05). Discussion: This study demonstrates a dose response association between short IPI and adverse birth outcomes, with no increased risk beyond 12 months. Findings suggest that longer IPI recommendations may be overly proscriptive. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF