Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
Department of Physiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
BMC Pregnancy Childbirth. 2022 Mar 30;22(1):268. doi: 10.1186/s12884-022-04611-4.
Women with previous cesarean deliveries, have a heightened risk of poor maternal and perinatal outcomes, associated with short interbirth intervals. We determined the prevalence of short interbirth interval, and associated factors, among women with antecedent cesarean deliveries who delivered at Mbarara Regional Referral Hospital (MRRH), in southwestern Uganda.
We conducted a cross-sectional study on the postnatal ward of MRRH from November 2020 to February 2021. We enrolled women who had antecedent cesarean deliveries through consecutive sampling. We obtained participants' socio-demographic and obstetric characteristics through interviewer-administered structured questionnaires. We defined short interbirth interval as an interval between two successive births of < 33 months. Modified Poisson regression was used to identify factors associated with short interbirth intervals.
Of 440 participants enrolled, most had used postpartum family planning (PPFP) prior to the current pregnancy (67.5%), and most of the pregnancies (57.2%) were planned. The mean age of the participants was 27.6 ± 5.0 years. Of the 440 women, 147 had a short interbirth interval, for a prevalence of 33% (95%CI: 29-38%). In multivariable analysis, non-use of PPFP (adjusted prevalence ratio [aPR] = 2.24; 95%CI: 1.57-3.20, P < 0.001), delivery of a still birth at an antecedent delivery (aPR = 3.95; 95%CI: 1.43-10.9, P = 0.008), unplanned pregnancy (aPR = 3.59; 95%CI: 2.35-5.49, P < 0.001), and young maternal age (aPR = 0.25 for < 20 years vs 20-34 years; 95%CI: 0.10-0.64, P = 0.004), were the factors significantly associated with short interbirth interval.
One out of every three womenwith antecedent caesarean delivery had a short interbirth interval. Short interbirth intervals were more common among women with history of still births, those who did not use postpartum family planning methods, and those whose pregnancies were unplanned, compared to their counterparts. Young mothers (< 20 years) were less likely to have short interbirth intervals compared to those who were 20 years or older. Efforts should be made to strengthen and scale up child-spacing programs targeting women with previous cesarean deliveries, given the high frequency of short interbirth intervals in this study population.
有剖宫产史的妇女，其母婴和围产期结局较差的风险增加，与分娩间隔较短有关。我们确定了在乌干达西南部姆巴拉拉地区转诊医院（MRRH）分娩的有剖宫产史的妇女中，短间隔分娩的流行情况及其相关因素。
我们于 2020 年 11 月至 2021 年 2 月在 MRRH 的产后病房进行了一项横断面研究。我们通过连续抽样纳入有剖宫产史的妇女。我们通过访谈员管理的结构化问卷获得参与者的社会人口统计学和产科特征。我们将分娩间隔定义为两次连续分娩之间的间隔<33 个月。采用修正泊松回归分析确定与短间隔分娩相关的因素。
在纳入的 440 名参与者中，大多数人在当前妊娠前使用了产后家庭计划生育（PPFP）（67.5%），大多数妊娠（57.2%）是计划妊娠。参与者的平均年龄为 27.6±5.0 岁。在 440 名妇女中，147 人分娩间隔较短，患病率为 33%（95%CI：29-38%）。多变量分析显示，未使用产后家庭计划生育（调整后患病率比[aPR]：2.24；95%CI：1.57-3.20，P<0.001）、前次分娩死胎（aPR：3.95；95%CI：1.43-10.9，P=0.008）、非计划妊娠（aPR：3.59；95%CI：2.35-5.49，P<0.001）和产妇年龄较小（aPR：<20 岁与 20-34 岁相比，0.25；95%CI：0.10-0.64，P=0.004）是与短间隔分娩相关的显著因素。
每三名有剖宫产史的妇女中就有一名分娩间隔较短。与对照组相比，有死胎史、未使用产后家庭计划生育方法和非计划妊娠的妇女，以及有短间隔分娩史的妇女，短间隔分娩更为常见。与 20 岁或以上的妇女相比，年龄较小的（<20 岁）母亲发生短间隔分娩的可能性较小。鉴于该研究人群中短间隔分娩的频率较高，应努力加强和扩大针对有剖宫产史妇女的儿童间隔方案。
