Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population

Jayme L Congdon; Rebecca J Baer; Jennet Arcara; Sky K Feuer; Anu Manchikanti Gómez; Deborah Karasek; Scott P Oltman; Matthew S Pantell; Kelli Ryckman; Laura Jelliffe-Pawlowski

doi:10.1007/s10995-022-03388-4

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Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population

Journal article

Open access

Peer reviewed

Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population

Jayme L Congdon, Rebecca J Baer, Jennet Arcara, Sky K Feuer, Anu Manchikanti Gómez, Deborah Karasek, Scott P Oltman, Matthew S Pantell, Kelli Ryckman and Laura Jelliffe-Pawlowski

Maternal and child health journal, Vol.26(5), pp.1115-1125

03/09/2022

DOI: 10.1007/s10995-022-03388-4

PMCID: PMC9023393

PMID: 35260953

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Abstract

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. 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). 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). 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.

Birth intervals

Family planning

Birth weight

Pregnancy outcome

Premature birth

Details

Title: Subtitle: Interpregnancy Interval and Birth Outcomes: A Propensity Matching Study in the California Population
Creators: Jayme L Congdon - University of California, San Francisco
Rebecca J Baer - University of California, San Francisco
Jennet Arcara - University of California, Berkeley
Sky K Feuer - University of California, San Francisco
Anu Manchikanti Gómez - University of California, Berkeley
Deborah Karasek - University of California, San Francisco
Scott P Oltman - University of California, San Francisco
Matthew S Pantell - University of California, San Francisco
Kelli Ryckman - University of Iowa
Laura Jelliffe-Pawlowski - University of California, San Francisco
Resource Type: Journal article
Publication Details: Maternal and child health journal, Vol.26(5), pp.1115-1125
DOI: 10.1007/s10995-022-03388-4
PMID: 35260953
PMCID: PMC9023393
NLM abbreviation: Matern Child Health J
eISSN: 1573-6628
Grant note: KL2 TR001870 / NCATS NIH HHS
Language: English
Date published: 03/09/2022
Academic Unit: Stead Family Department of Pediatrics; Epidemiology
Record Identifier: 9984226810102771

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