Weiss Ari, Sela Hen Y, Grisaru-Granovsky Sorina, Rottenstreich Misgav
Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem 91031, Israel.
Department of Nursing, Jerusalem College of Technology, Jerusalem 9116001, Israel.
J Clin Med. 2023 Mar 29;12(7):2576. doi: 10.3390/jcm12072576.
To evaluate the maternal and neonatal outcomes of women with short interpregnancy intervals (IPI < 6 months) following a multifetal pregnancy.
A multicenter retrospective cohort study of women with an index multifetal delivery and a subsequent singleton gestation between 2005 and 2021. The obstetrical outcomes of pregnancies following short IPI (<6 months) were compared to those with an IPI of 18-48 months. Additional analyses were also conducted for the other IPI groups: 7-17 months, and longer than 49 months, while women with an IPI of 18-48 months served as the reference group. The primary outcome was preterm birth (<37 weeks) rate. Secondary outcomes were other adverse maternal and neonatal outcomes. Univariate and multiple logistic regression analyses were performed.
Overall, 2514 women had a primary multifetal delivery with a subsequent singleton gestation at our medical centers; 160 (6.4%) had a short IPI, and 1142 (45.4%) had an optimal IPI. Women with a singleton gestation following a short IPI were younger, with lower rates of previous cesarean and fertility treatments. Women in the short IPI group had significantly higher rates of preterm birth <37 weeks, anemia (Hb < 11 gr%) on admission to the delivery room, and placental abruption. Multivariable logistic regression analysis demonstrated that short IPI is associated with an increased risk for preterm birth (aOR 2.39, 95% CI 1.12-5.11, = 0.03).
Short IPI following a multifetal gestation is associated with an increased risk for preterm birth in subsequent singleton pregnancy.
评估多胎妊娠后妊娠间隔时间短（IPI<6个月）的妇女的母婴结局。
一项对2005年至2021年间首次多胎分娩并随后单胎妊娠的妇女进行的多中心回顾性队列研究。将短IPI（<6个月）后妊娠的产科结局与IPI为18 - 48个月的妇女的结局进行比较。还对其他IPI组进行了额外分析：7 - 17个月和超过49个月，而IPI为18 - 48个月的妇女作为参照组。主要结局是早产（<37周）率。次要结局是其他不良母婴结局。进行了单因素和多因素逻辑回归分析。
总体而言，2514名妇女在我们的医疗中心进行了首次多胎分娩并随后单胎妊娠；160名（6.4%）IPI短，1142名（45.4%）IPI最佳。短IPI后单胎妊娠的妇女更年轻，既往剖宫产和生育治疗率更低。短IPI组的妇女<37周早产、产房入院时贫血（血红蛋白<11g%）和胎盘早剥的发生率显著更高。多因素逻辑回归分析表明，短IPI与早产风险增加相关（调整后比值比2.39，95%置信区间1.12 - 5.11，P = 0.03）。
多胎妊娠后短IPI与随后单胎妊娠早产风险增加相关。
