Saint Louis University School of Medicine, Saint Louis, MO, USA.
Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA.
J Matern Fetal Neonatal Med. 2020 Nov;33(22):3809-3815. doi: 10.1080/14767058.2019.1586878. Epub 2019 Mar 8.
For women who suffer from abruption in the first pregnancy, the extent to which birth spacing has an impact on maternal and fetal outcomes in a second pregnancy remains unclear. To examine the effect of interpregnancy interval (IPI) after a first pregnancy complicated by placental abruption, on adverse maternal and fetal outcomes in a subsequent pregnancy. This was a population-based retrospective cohort study using maternally-linked Missouri birth registry from 1989 to 2005 ( = 2069). Exposure of interest was IPI and outcomes were placental abruption, preeclampsia, preterm birth, small for gestational age, cesarean delivery, and neonatal plus fetal deaths (neofetal death) in a second pregnancy. Logistic regressions were used to assess the association between IPI and the outcomes. Compared with women with an IPI of 1-2 years, those with short IPI (<1 year) were more likely to experience preterm birth (aOR 3.01, 95% CI 1.71-5.28) and neonatal death (aOR 3.52, 95% CI 1.24-10.02) in their subsequent pregnancy. No significant associations between IPI and recurrent placental abruption or preeclampsia were detected. Women who become pregnant in less than a year's time of an initial placental abruption are at increased risk for preterm birth and neofetal death in a subsequent pregnancy. Other ischemic placental disease conditions are also shown to have serious health implications for a woman's next pregnancy.
对于首次妊娠发生胎盘早剥的女性,分娩间隔对其后续妊娠母婴结局的影响尚不清楚。本研究旨在探讨首次妊娠合并胎盘早剥后妊娠间隔(interpregnancy interval,IPI)对后续妊娠母婴结局的影响。这是一项基于人群的回顾性队列研究,使用了 1989 年至 2005 年密苏里州出生登记处的母婴关联数据( = 2069)。本研究的暴露因素为 IPI,结局指标包括后续妊娠中的胎盘早剥、子痫前期、早产、小于胎龄儿、剖宫产和新生儿及胎儿死亡(neofetal death)。采用逻辑回归评估 IPI 与结局之间的关系。与 IPI 为 1-2 年的女性相比,IPI 较短(<1 年)的女性在后续妊娠中更易发生早产(aOR 3.01,95%CI 1.71-5.28)和新生儿死亡(aOR 3.52,95%CI 1.24-10.02)。IPI 与复发性胎盘早剥或子痫前期之间无显著相关性。首次胎盘早剥后不到一年再次怀孕的女性,其后续妊娠发生早产和新生儿死亡的风险增加。其他缺血性胎盘疾病也会对女性的下一次妊娠产生严重的健康影响。