Cofer Flojaune Griffin, Fridman Moshe, Lawton Elizabeth, Korst Lisa M, Nicholas Lisa, Gregory Kimberly D
Maternal, Child and Adolescent Health Division, California Department of Public Health, 1615 Capitol Avenue, MS 8306, P.O. Box 997420, Sacramento, CA, 95899-7420, USA.
AMF Consulting, Los Angeles, CA, USA.
Matern Child Health J. 2016 Nov;20(Suppl 1):43-51. doi: 10.1007/s10995-016-2180-0.
Objectives The goals of interconception care are to optimize women's health and encourage adequate spacing between pregnancies. Our study calculated trends in interpregnancy interval (IPI) patterns and measured the association of differing intervals with birth outcomes in California. Methods Women with "non-first birth" deliveries in California hospitals from 2007 to 2009 were identified in a linked birth certificate and patient discharge dataset and divided into three IPI birth categories: <6, 6-17, and 18-50 months. Trends over the study period were tested using the Cochran-Armitage two-sided linear trend test. Chi square tests were used to test the association between IPI and patient characteristics and selected singleton adverse birth outcomes. Results Of 645,529 deliveries identified as non-first births, 5.6 % had an IPI <6 months, 33.1 % had an IPI of 6-17 months, and 61.3 % had an IPI of 18-50 months. The prevalence of IPI <6 months declined over the 3-year period (5.8 % in 2007 to 5.3 % in 2009, trend p value <0.0001).Women with an IPI <6 months had a significantly higher prevalence of early preterm birth (<34 weeks), low birthweight (<2500 g), neonatal complications, neonatal death and severe maternal complications than women with a 6-17 month or 18-50 month IPI (p < 0.005). Comparing those with a 6-17 month vs 18-50 month IPI, there were increased early preterm births and decreased maternal complications, complicated delivery, and stillbirth/intrauterine fetal deaths among those with a shorter IPI. Conclusions for Practice In California, women with an IPI <6 months were at increased risk for several birth outcomes, including composite morbidity measures.
目标 孕前保健的目标是优化女性健康状况并鼓励妊娠之间有足够的间隔时间。我们的研究计算了妊娠间隔期（IPI）模式的趋势，并测定了加利福尼亚州不同间隔时间与分娩结局之间的关联。方法 在一份关联的出生证明和患者出院数据集里，识别出2007年至2009年在加利福尼亚州医院进行“非头胎”分娩的女性，并将其分为三个IPI分娩类别：<6个月、6 - 17个月和18 - 50个月。使用 Cochr an - Armitage双侧线性趋势检验来检验研究期间的趋势。卡方检验用于检验IPI与患者特征以及选定的单胎不良分娩结局之间的关联。结果 在645,529例被确定为非头胎的分娩中，5.6%的IPI<6个月，33.1%的IPI为6 - 17个月，61.3%的IPI为18 - 50个月。在这3年期间，IPI<6个月的患病率有所下降（从2007年的5.8%降至2009年的5.3%，趋势p值<0.0001）。与IPI为6 - 17个月或18 - 50个月的女性相比，IPI<6个月的女性早期早产（<34周）、低出生体重（<2500克）、新生儿并发症、新生儿死亡和严重孕产妇并发症的患病率显著更高（p<0.005）。比较IPI为6 - 17个月与18 - 50个月的女性，IPI较短的女性中早期早产增加，而孕产妇并发症、复杂分娩以及死产/宫内胎儿死亡减少。实践结论 在加利福尼亚州，IPI<6个月的女性出现多种分娩结局的风险增加，包括综合发病率指标。
