Department of Obstetrics and Gynecology, University of Ottawa Faculty of Medicine, and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Am J Obstet Gynecol. 2014 Jun;210(6):564.e1-8. doi: 10.1016/j.ajog.2014.02.002. Epub 2014 Feb 6.
To assess the association between interpregnancy intervals and congenital anomalies.
A retrospective cohort study on women who had 2 consecutive singleton births from 1999-2007 was conducted using a linked dataset from the Alberta Perinatal Health Program, the Alberta Congenital Anomalies Surveillance System, and the Alberta Health and Wellness Database. Interpregnancy interval was calculated as the interval between 2 consecutive deliveries minus the gestational age of the second infant. The primary outcome of congenital anomaly was defined using the International Classification of Diseases. Maternal demographic and obstetric characteristics and interpregnancy intervals were included in multivariable logistic regression models for congenital anomalies.
The study included 46,243 women, and the overall rate of congenital anomalies was 2.2%. Both short and long interpregnancy intervals were associated with congenital anomalies. The lowest rate was for the 12-17 months category (1.9%, reference category), and increased rates were seen for both short intervals (2.5% for 0-5 months; adjusted odds ratio, 1.32; 95% confidence interval, 1.01-1.72) and long intervals (2.3% for 24-35 months; adjusted odds ratio, 1.25; 95% confidence interval, 1.02-1.52). Statistically significant associations were also observed for folate independent anomalies, but not for folate dependent anomalies.
The risk of congenital anomalies appears to increase with both short and long interpregnancy intervals. This study supports the limited existing studies in the literature, further explores the types of anomalies affected, and has implications for further research and prenatal risk assessment.
评估两次妊娠间隔与先天畸形的关系。
本研究采用 1999 年至 2007 年连续两次单胎分娩的妇女的回顾性队列研究，使用艾伯塔省围产期健康计划、艾伯塔省先天畸形监测系统和艾伯塔省健康和保健数据库的链接数据集。两次妊娠间隔定义为两次分娩之间的间隔减去第二个婴儿的胎龄。先天性畸形的主要结局采用国际疾病分类法定义。多变量逻辑回归模型纳入了母亲的人口统计学和产科特征以及两次妊娠间隔，以评估先天性畸形。
该研究纳入了 46243 名妇女，先天性畸形的总发生率为 2.2%。短间隔和长间隔妊娠与先天畸形均有关。最短间隔（0-5 个月）的发生率最高（2.5%，参考类别），而较长间隔（24-35 个月）的发生率也有所增加（调整后的优势比为 1.32，95%置信区间为 1.01-1.72）。叶酸独立畸形也存在显著关联，但叶酸依赖畸形则无。
先天畸形的风险似乎随着两次妊娠间隔的缩短和延长而增加。本研究支持了文献中有限的现有研究，进一步探讨了受影响的畸形类型，并对进一步的研究和产前风险评估具有启示意义。
