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Beyond birth outcomes: Interpregnancy interval and injury-related infant mortality.
- Source :
-
Paediatric & Perinatal Epidemiology . Sep2019, Vol. 33 Issue 5, p360-370. 11p. - Publication Year :
- 2019
-
Abstract
- <bold>Background: </bold>Several studies have examined the association between IPI and birth outcomes, but few have explored the association between interpregnancy interval (IPI) and postnatal outcomes.<bold>Objective: </bold>We examined the association between IPI and injury-related infant mortality, a leading cause of postneonatal mortality.<bold>Methods: </bold>We used 2011-2015 US period-linked birth-infant death vital statistics data to generate a multiyear birth cohort of non-first-born singleton births (N = 9 782 029). IPI was defined as the number of months between a live birth and the start of the pregnancy leading to the next live birth. Causes of death in the first year of life were identified using ICD-10 codes. Hazard ratios (HR) for IPI categories were estimated using Cox proportional hazards models adjusted for birth order, county poverty level, and maternal characteristics (marital status, race/ethnicity, education, age at previous birth).<bold>Results: </bold>After adjustment, overall infant mortality (48.1 per 10 000 births) was higher for short and long IPIs compared with IPI 18-23 months (reference): <6, aHR 1.61, 95% CI 1.54, 1.68; 6-11, aHR 1.22, 95% CI 1.17, 1.26; and 60+ months, aHR 1.12, 95% CI 1.08, 1.16. In comparison, the risk of injury-related infant mortality (4.4 per 10 000 births) decreased with longer IPIs: <6, aHR 1.77, 95% CI 1.55, 2.01; 6-11, aHR 1.41, 95% CI 1.25, 1.59; 12-17, aHR 1.25, 95% CI 1.10, 1.41; 24-59, aHR 0.78, 95% CI 0.69, 0.87; and 60+ months, aHR 0.55, 95% CI 0.48, 0.62.<bold>Conclusion: </bold>Unlike overall infant mortality, injury-related infant mortality decreased with IPI length. While injury-related deaths are rare, these patterns suggest that the timing between births may be a marker of risk for fatal infant injuries. The first year postpartum may be an ideal time for the delivery of evidence-based injury prevention programmes as well as family planning services. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BIRTH certificates
*BIRTH intervals
*SIBLINGS
*CHILD abuse
*COMPARATIVE studies
*INFANT mortality
*MATERNAL age
*RESEARCH methodology
*MEDICAL cooperation
*POSTPARTUM depression
*RESEARCH
*RESEARCH funding
*WOUNDS & injuries
*DEATH certificates
*SOCIOECONOMIC factors
*EVALUATION research
*PROPORTIONAL hazards models
*RETROSPECTIVE studies
Subjects
Details
- Language :
- English
- ISSN :
- 02695022
- Volume :
- 33
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Paediatric & Perinatal Epidemiology
- Publication Type :
- Academic Journal
- Accession number :
- 138831844
- Full Text :
- https://doi.org/10.1111/ppe.12575