Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study
Objective To examine if the association between interpregnancy interval (IPI) and pregnancy complications varies by the presence or absence of previous complications.Design and setting Population-based longitudinally linked cohort study in Western Australia (WA).Participants Mothers who had their fi...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2021-12-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/12/e046962.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850258442801905664 |
|---|---|
| author | Annette K Regan Gavin F Pereira Gizachew Assefa Tessema Amanuel Tesfay Gebremedhin |
| author_facet | Annette K Regan Gavin F Pereira Gizachew Assefa Tessema Amanuel Tesfay Gebremedhin |
| author_sort | Annette K Regan |
| collection | DOAJ |
| description | Objective To examine if the association between interpregnancy interval (IPI) and pregnancy complications varies by the presence or absence of previous complications.Design and setting Population-based longitudinally linked cohort study in Western Australia (WA).Participants Mothers who had their first two (n=252 368) and three (n=96 315) consecutive singleton births in WA between 1980 and 2015.Outcome measures We estimated absolute risks (AR) of preeclampsia (PE) and gestational diabetes (GDM) for 3–60 months of IPI according to history of each outcome. We modelled IPI using restricted cubic splines and reported adjusted relative risk (RRs) with 95% CI at 3, 6, 12, 24, 36, 48 and 60 months, with 18 months as reference.Results Risks of PE and GDM were 9.5%, 2.6% in first pregnancies, with recurrence rates of 19.3% and 41.5% in second pregnancy for PE and GDM, respectively. The AR of GDM ranged from 30% to 43% across the IPI range for mothers with previous GDM compared with 2%–8% for mothers without previous GDM. For mothers with no previous PE, greater risks were observed for IPIs at 3 months (RR 1.24, 95% CI 1.07 to 1.43) and 60 months (RR 1.40, 95% CI 1.29 to 1.53) compared with 18 months. There was insufficient evidence for increased risk of PE at shorter IPIs of <18 months for mothers with previous PE. Shorter IPIs of <18 months were associated with lower risk than at IPIs of 18 months for mothers with no previous GDM.Conclusions The associations between IPIs and risk of PE or GDM on subsequent pregnancies are modified by previous experience with these conditions. Mothers with previous complications had higher absolute, but lower RRs than mothers with no previous complications. However, IPI remains a potentially modifiable risk factor for mothers with previous complicated pregnancies. |
| format | Article |
| id | doaj-art-7e7f6772c09d46d19212ebaf7aa0c45e |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-7e7f6772c09d46d19212ebaf7aa0c45e2025-08-20T01:56:10ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2020-046962Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort studyAnnette K Regan0Gavin F Pereira1Gizachew Assefa Tessema2Amanuel Tesfay Gebremedhin3Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, USACentre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, NorwayCurtin School of Population Health, Curtin University, Perth, Western Australia, AustraliaWesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, AustraliaObjective To examine if the association between interpregnancy interval (IPI) and pregnancy complications varies by the presence or absence of previous complications.Design and setting Population-based longitudinally linked cohort study in Western Australia (WA).Participants Mothers who had their first two (n=252 368) and three (n=96 315) consecutive singleton births in WA between 1980 and 2015.Outcome measures We estimated absolute risks (AR) of preeclampsia (PE) and gestational diabetes (GDM) for 3–60 months of IPI according to history of each outcome. We modelled IPI using restricted cubic splines and reported adjusted relative risk (RRs) with 95% CI at 3, 6, 12, 24, 36, 48 and 60 months, with 18 months as reference.Results Risks of PE and GDM were 9.5%, 2.6% in first pregnancies, with recurrence rates of 19.3% and 41.5% in second pregnancy for PE and GDM, respectively. The AR of GDM ranged from 30% to 43% across the IPI range for mothers with previous GDM compared with 2%–8% for mothers without previous GDM. For mothers with no previous PE, greater risks were observed for IPIs at 3 months (RR 1.24, 95% CI 1.07 to 1.43) and 60 months (RR 1.40, 95% CI 1.29 to 1.53) compared with 18 months. There was insufficient evidence for increased risk of PE at shorter IPIs of <18 months for mothers with previous PE. Shorter IPIs of <18 months were associated with lower risk than at IPIs of 18 months for mothers with no previous GDM.Conclusions The associations between IPIs and risk of PE or GDM on subsequent pregnancies are modified by previous experience with these conditions. Mothers with previous complications had higher absolute, but lower RRs than mothers with no previous complications. However, IPI remains a potentially modifiable risk factor for mothers with previous complicated pregnancies.https://bmjopen.bmj.com/content/11/12/e046962.full |
| spellingShingle | Annette K Regan Gavin F Pereira Gizachew Assefa Tessema Amanuel Tesfay Gebremedhin Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study BMJ Open |
| title | Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study |
| title_full | Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study |
| title_fullStr | Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study |
| title_full_unstemmed | Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study |
| title_short | Association between interpregnancy interval and pregnancy complications by history of complications: a population-based cohort study |
| title_sort | association between interpregnancy interval and pregnancy complications by history of complications a population based cohort study |
| url | https://bmjopen.bmj.com/content/11/12/e046962.full |
| work_keys_str_mv | AT annettekregan associationbetweeninterpregnancyintervalandpregnancycomplicationsbyhistoryofcomplicationsapopulationbasedcohortstudy AT gavinfpereira associationbetweeninterpregnancyintervalandpregnancycomplicationsbyhistoryofcomplicationsapopulationbasedcohortstudy AT gizachewassefatessema associationbetweeninterpregnancyintervalandpregnancycomplicationsbyhistoryofcomplicationsapopulationbasedcohortstudy AT amanueltesfaygebremedhin associationbetweeninterpregnancyintervalandpregnancycomplicationsbyhistoryofcomplicationsapopulationbasedcohortstudy |