Koullali Bouchra, Kamphuis Esme I, Hof Michel H P, Robertson Sarah A, Pajkrt Eva, de Groot Christianne J M, Mol Ben W J, Ravelli Anita C J
Department of Obstetrics and Gynecology, Academic Medical Centre, Amsterdam, The Netherlands.
Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Centre, Amsterdam, The Netherlands.
Am J Perinatol. 2017 Jan;34(2):174-182. doi: 10.1055/s-0036-1584896. Epub 2016 Jul 1.
We assessed, in women with a previous spontaneous preterm birth, the effect of interpregnancy interval on the subsequent preterm birth rate. Retrospective cohort study. A nationwide longitudinal dataset of the the Netherlands Perinatal Registry. Women with three sequential singleton pregnancies between 1999 and 2009 and a spontaneous preterm birth <37 weeks in the first pregnancy. We evaluated the impact of interpregnancy interval on the course of the next pregnancies. Antenatal death and/or congenital abnormalities were excluded. Conventional and conditional logistic regression analysis were applied. We adjusted for maternal age, ethnicity, socioeconomic status, artificial reproductive techniques, and year of birth. Outcomes studied were preterm birth <37 weeks, <32 weeks, low birth weight <2500 g, and small for gestational age <10th percentile. Among 2,361 women with preterm birth in the first pregnancy, logistic regression analysis indicated a significant effect of a short interpregnancy interval (0-5 mo) on recurrent preterm birth <37 weeks (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.62-3.05), <32 weeks (OR, 2.90; 95% CI, 1.43-5.87), and low birth weight (OR, 2.69; 95% CI, 1.79-4.03). In addition, a long interval (≥60 mo) had a significant effect on preterm birth <37 weeks (OR, 2.19; 95% CI, 1.29-3.74). Conditional logistic regression analysis confirmed the effect of a short interval on the recurrence of preterm birth rate <37 weeks and low birth weight. In women with a previous spontaneous preterm birth, a short interpregnancy interval has a strong impact on the risk of preterm birth before 37 weeks and low birth weight in the next pregnancy, irrespective of the type of analysis performed.
我们评估了既往有自发性早产史的女性中，妊娠间隔对后续早产率的影响。回顾性队列研究。荷兰围产期登记处的全国性纵向数据集。1999年至2009年间有三次连续单胎妊娠且首次妊娠发生自发性早产（孕周<37周）的女性。我们评估了妊娠间隔对接下来妊娠过程的影响。排除产前死亡和/或先天性异常情况。应用传统和条件逻辑回归分析。我们对产妇年龄、种族、社会经济地位、辅助生殖技术和出生年份进行了校正。研究的结局包括孕周<37周、<32周的早产、出生体重<2500 g的低出生体重儿以及小于胎龄儿（<第10百分位数）。在首次妊娠发生早产的2361名女性中，逻辑回归分析表明，妊娠间隔短（0 - 5个月）对孕周<37周的复发性早产（比值比[OR]，2.22；95%置信区间[CI]，1.62 - 3.05）、<32周的早产（OR，2.90；95% CI，1.43 - 5.87）和低出生体重（OR，2.69；95% CI，1.79 - 4.03）有显著影响。此外，妊娠间隔长（≥60个月）对孕周<37周的早产有显著影响（OR，2.19；95% CI，1.29 - 3.74）。条件逻辑回归分析证实了妊娠间隔短对孕周<37周的早产复发率和低出生体重的影响。在既往有自发性早产史的女性中，无论进行何种分析类型，妊娠间隔短对下次妊娠37周前早产风险和低出生体重均有强烈影响。
