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Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh

  1. J DaVanzo1,*,
  2. L Hale2,
  3. A Razzaque3,
  4. M Rahman4

Article first published online: 6 JUL 2007

DOI: 10.1111/j.1471-0528.2007.01338.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 114, Issue 9, pages 1079–1087, September 2007

Additional Information

How to Cite

DaVanzo, J., Hale, L., Razzaque, A. and Rahman, M. (2007), Effects of interpregnancy interval and outcome of the preceding pregnancy on pregnancy outcomes in Matlab, Bangladesh. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 1079–1087. doi: 10.1111/j.1471-0528.2007.01338.x

Author Information

  1. 1

    Labor and Population Program, The RAND Corporation, Santa Monica, CA, USA

  2. 2

    Department of Preventive Medicine, State University of New York, Stony Brook, New York, NY, USA

  3. 3

    International Center for Diarrheal Disease Research, Dhaka, Bangladesh

  4. 4

    Pathfinder International, Watertown, MA, USA

*Dr J DaVanzo, 16541 Akron Street, Pacific Palisades, Los Angeles, CA, USA 90272. Email julie@rand.org

Publication History

  1. Issue published online: 6 JUL 2007
  2. Article first published online: 6 JUL 2007
  3. Accepted 25 January 2007. Published OnlineEarly 6 July 2007.

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Keywords:

  • Birth spacing;
  • fetal loss;
  • induced abortion;
  • interpregnancy intervals;
  • miscarriage;
  • pregnancy outcomes;
  • pregnancy spacing;
  • stillbirth

Objective  To estimate the effects on pregnancy outcomes of the duration of the preceding interpregnancy interval (IPI) and type of pregnancy outcome that began the interval.

Design  Observational population-based study.

Setting  The Maternal Child Health–Family Planning (MCH–FP) area of Matlab, Bangladesh.

Population  A total of 66 759 pregnancy outcomes that occurred between 1982 and 2002.

Methods Bivariate tabulations and multinomial logistic regression analysis.

Main outcome measures  Pregnancy outcomes (live birth, stillbirth, miscarriage [spontaneous fetal loss prior to 28 weeks], and induced abortion).

Results  When socio-economic and demographic covariates are controlled, of the IPIs that began with a live birth, those <6 months in duration were associated with a 7.5-fold increase in the odds of an induced abortion (95% CI 6.0–9.4), a 3.3-fold increase in the odds of a miscarriage (95% CI 2.8–3.9), and a 1.6-fold increase in the odds of a stillbirth (95% CI 1.2–2.1) compared with 27- to 50-month IPIs. IPIs of 6–14 months were associated with increased odds of induced abortion (2.0, 95% CI 1.5–2.6). IPIs ≥ 75 months were associated with increased odds of all three types of non-live-birth (NLB) outcomes but were not as risky as very short intervals. IPIs that began with a NLB were generally more likely to end with the same type of NLB.

Conclusions  Women whose pregnancies are between 15 and 75 months after a preceding pregnancy outcome (regardless of its type) have a lower likelihood of fetal loss than those with shorter or longer IPIs. Those with a preceding NLB outcome deserve special attention in counselling and monitoring.

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