Heisecke Silvina L, Campaña Hebe, Santos María R, López Camelo Jorge S, Rittler Mónica
Dirección de Investigación, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina (Heisecke).
Laboratorio de Epidemiología Genética, Centro de Educación Médica e Investigaciones Clínicas-Consejo Nacional de Investigaciones Científicas y Técnicas (CEMIC-CONICET), Ciudad Autónoma de Buenos Aires, Argentina (Campaña, López Camelo, Rittler).
AJOG Glob Rep. 2024 Oct 9;4(4):100406. doi: 10.1016/j.xagr.2024.100406. eCollection 2024 Nov.
Interbirth interval (IBI), the time between consecutive births, has been tied to perinatal outcomes.
To analyze adverse perinatal events following short IBI in a large South American sample.
Observational, retrospective, hospital-based study including malformed and nonmalformed live- and stillbirths. Outcomes were preterm birth (PTB), low birth weight (LBW), and specific birth defects. Logistic regressions were used to evaluate the risk of selected variables for short IBI and for adverse outcomes after short IBI, adjusting by confounders. Bayesian networks exhibited relationships among short IBI, outcomes, and variables.
Short IBI rate was 2%-3%. Maternal age and a previous abortion were the main confounders. A significant high risk for short IBI was found in mothers ≤19 years while mothers ≥30 were at low risk, mediated by a previous abortion. The risk of short IBI, adjusted by confounders, was significant for LBW but not for PTB. An unadjusted risk of short IBI was observed for gastroschisis, which disappeared after adjusting for confounders. Maternal age ≤19 and previous abortion were directly related with gastroschisis; the relationship between gastroschisis and short IBI occurred through any of these two variables. A direct relationship between gastroschisis and maternal age ≥30 was observed.
Only young mothers were directly related with short IBI. In older mothers, a short IBI mainly occurred after a previous abortion. Short IBI was a risk factor only for LBW. The PTB and gastroschisis relationship with short IBI was indirect, mediated by young maternal age and/or a previous abortion.
生育间隔（IBI），即连续两次生育之间的时间间隔，与围产期结局相关。
分析在一个大型南美样本中，短生育间隔后的不良围产期事件。
基于医院的观察性回顾性研究，纳入畸形和非畸形的活产及死产。结局指标为早产（PTB）、低出生体重（LBW）和特定出生缺陷。采用逻辑回归评估短生育间隔的选定变量以及短生育间隔后不良结局的风险，并对混杂因素进行校正。贝叶斯网络展示了短生育间隔、结局和变量之间的关系。
短生育间隔率为2%-3%。产妇年龄和既往流产是主要的混杂因素。发现年龄≤19岁的母亲发生短生育间隔的风险显著较高，而年龄≥30岁的母亲风险较低，这一情况由既往流产介导。校正混杂因素后，短生育间隔与低出生体重的风险具有统计学意义，但与早产无关。未校正时，短生育间隔与腹裂相关，校正混杂因素后该关联消失。产妇年龄≤19岁和既往流产与腹裂直接相关；腹裂与短生育间隔之间的关系通过这两个变量中的任何一个发生。观察到腹裂与产妇年龄≥30岁之间存在直接关系。
只有年轻母亲与短生育间隔直接相关。在年长母亲中，短生育间隔主要发生在既往流产之后。短生育间隔仅是低出生体重的一个危险因素。早产和腹裂与短生育间隔的关系是间接的，由年轻产妇年龄和/或既往流产介导。
