Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.
Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia; School of Population Health, Texas A&M University, College Station.
Ann Epidemiol. 2023 Sep;85:108-112.e4. doi: 10.1016/j.annepidem.2023.05.011. Epub 2023 May 18.
To ascertain whether adverse pregnancy outcomes at first pregnancy influence subsequent interpregnancy intervals (IPIs) and whether the size of this effect varies with IPI distribution METHODS: We included 251,892 mothers who gave birth to their first two singletons in Western Australia, from 1980 to 2015. Using quantile regression, we investigated whether gestational diabetes, hypertension, or preeclampsia in the first pregnancy influenced IPI to subsequent pregnancy and whether effects were consistent across the IPI distribution. We considered intervals at the 25th centile of the distribution as 'short' and the 75th centile as 'long'.
The average IPI was 26.6 mo. It was 0.56 mo (95% CI: 0.25-0.88 mo) and 1.12 mo (95% CI: 0.56 - 1.68 mo) longer after preeclampsia, and gestational hypertension respectively. There was insufficient evidence to suggest that the association between previous pregnancy complications and IPI differed by the extent of the interval. However, associations with marital status, race/ethnicity and stillbirth contributed to either shortening or prolonging IPIs differently across the distribution of IPI.
Mothers with preeclampsia and gestational hypertension had slightly longer subsequent IPIs than mothers whose pregnancies were not complicated by these conditions. However, the extent of the delay was small (<2 mo).
确定首次妊娠的不良妊娠结局是否会影响随后的妊娠间隔(interpregnancy intervals,IPI),以及这种影响的大小是否随 IPI 分布而变化。
我们纳入了 1980 年至 2015 年在澳大利亚西部首次分娩的 251892 名单胎母亲。我们使用分位数回归来研究首次妊娠中的糖尿病、高血压或先兆子痫是否会影响到随后的妊娠间隔,以及这种影响是否在整个 IPI 分布中一致。我们将分布的第 25 百分位数的间隔视为“短”,第 75 百分位数的间隔视为“长”。
平均 IPI 为 26.6 个月。与无妊娠并发症的母亲相比,患有先兆子痫的母亲的 IPI 延长了 0.56 个月(95%CI:0.25-0.88 个月),患有妊娠期高血压的母亲的 IPI 延长了 1.12 个月(95%CI:0.56-1.68 个月)。没有足够的证据表明,先前妊娠并发症与 IPI 之间的关联在间隔程度上存在差异。然而,与婚姻状况、种族/民族和死胎有关的关联导致 IPI 在分布上的缩短或延长方式不同。
患有先兆子痫和妊娠期高血压的母亲随后的 IPI 比没有这些疾病的母亲稍长,但延迟的程度很小(<2 个月)。