Short interpregnancy interval and adverse pregnancy outcomes among women in a Middle Eastern country
A short interpregnancy interval is associated with several maternal and neonatal complications. In Oman, the incidence of short interpregnancy interval is well documented in the annual health report, but evidence is lacking on its impact on adverse pregnancy outcomes. This study examined short interpregnancy interval, its risk factors and its association with the prevalence of adverse pregnancy outcomes among Omani pregnant women.
A retrospective matched case–control design was adopted. Data were collected from medical records between January and December 2020. A total of 597 pregnant women from two tertiary care hospitals in Oman were included.
There was a significant relationship between interpregnancy interval and the prevalence of adverse maternal and perinatal outcomes, including postpartum haemorrhage, iron deficiency anemia, preterm birth and low birth weight. Significant risk factors for a short interpregnancy interval were advanced maternal age, young age at first birth, low parity and previous perinatal loss.
Encouraging acceptance of birth spacing through the use of contraception would signify a notable change in cultural values that can act as a barrier to birth spacing. This would therefore improve pregnancy outcomes.
Inter pregnancy interval is defined as ‘the time between the end of a pregnancy and the start of another pregnancy’ (World Health Organization (WHO), 2005). A short interpregnancy interval has been defined by the WHO (2013) as ‘a period of less than 24 months from last delivery to the current pregnancy’ while a long interval is defined as ‘an interval of longer than 59 months’. The recommended optimal interpregnancy interval according to many international agencies is to leave at least 2 years after a live birth or 6 months after spontaneous miscarriage or induced abortion before conceiving another pregnancy (Marinovich et al, 2019).
Although birth spacing is becoming a prominent health promotion intervention for women and children's health, the prevalence of short interpregnancy intervals is rising. In low-income countries such as Nigeria, the prevalence of short interpregnancy interval ranges from 19.4–65.9% (Bassey et al, 2016). Pregnancies conceived after a short interpregnancy interval place both mother and fetus in danger, while the optimal interpregnancy interval is a crucial driver of maternal health and favours perinatal outcomes (Arabin and Baschat, 2017). Therefore, maintaining an optimal interval between pregnancies is necessary to avoid high-risk pregnancies (Gilmore et al, 2015).
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