Association of interpregnancy interval and risk of adverse pregnancy outcomes in woman by different previous gestational ages

作     者：Peiran Chen Yi Mu Zheng Liu Yanping Wang Xiaohong Li Li Dai Qi Li Mingrong Li Yanxia Xie Juan Liang Jun Zhu 

作者机构：National Office for Maternal and Child Health Surveillance of ChinaWest China Second University HospitalSichuan UniversityChengduSichuan 610066China Department of ObstetricsWest China Second University HospitalSichuan UniversityChengduSichuan 610066China Key Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationSichuan UniversityChengduSichuan 610066China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2024年第137卷第1期

页      面：87-96页

核心收录：

学科分类：1002[医学-临床医学] 100211[医学-妇产科学] 10[医学] 

基　　金：supported by grants from the National Key Research and Development Program of China(Nos.2022YFC2704600,2022YFC2704605,2019YFC1005100) National Health Commission of the People’s Republic of China,the China Medical Board(No.11-065) WHO(No.CHN-12-MCN-004888) UNICEF(No.2016EJH016) 

主　　题：Interpregnancy interval Fertility policy Gestational age Preterm birth Gestational hypertension Diabetes mellitus in pregnancy 

摘      要：Background:With an increasing proportion of multiparas,proper interpregnancy intervals(IPIs)are urgently ***,the association between IPIs and adverse perinatal outcomes has always been *** study aimed to explore the association between IPIs and adverse outcomes in different fertility policy periods and for different previous gestational ***:We used individual data from China’s National Maternal Near Miss Surveillance System between 2014 and *** Poisson models with restricted cubic splines were *** adverse outcome was analyzed separately in the overall model and stratified *** stratified models included different categories of fertility policy periods(2014-2015,2016-2017,and 2018-2019)and infant gestational age in previous pregnancy(28 weeks,28-36 weeks,and≥37 weeks).Results:There were 781,731 pregnancies enrolled in this study.A short IPI(≤6 months)was associated with an increased risk of preterm birth(OR[95%CI]:1.63[1.55,1.71]for vaginal delivery[VD]and 1.10[1.03,1.19]for cesarean section[CS]),low Apgar scores and small for gestational age(SGA),and a decreased risk of diabetes mellitus in pregnancy,preeclampsia or eclampsia,and gestational hypertension.A long IPI(≥60 months)was associated with an increased risk of preterm birth(OR[95%CI]:1.18[1.11,1.26]for VD and 1.39[1.32,1.47]for CS),placenta previa,postpartum hemorrhage,diabetes mellitus in pregnancy,preeclampsia or eclampsia,and gestational *** policy changes had little effect on the association of IPIs and adverse maternal and neonatal *** estimated risk of preterm birth,low Apgar scores,SGA,diabetes mellitus in pregnancy,and gestational hypertension was more profound among women with previous term births than among those with preterm births or pregnancy ***:For pregnant women with shorter or longer IPIs,more targeted health care measures during pregnancy should be formulated according to infant gestational age in