Mu Ruowen, Wu Jie, Yu Danyang, Xu Zhangye
Department of Gynecology and Obstetrics, The Second Affiliated Hospital, Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325088, China.
BMC Pregnancy Childbirth. 2025 Aug 1;25(1):805. doi: 10.1186/s12884-025-07935-z.
Inter-pregnancy interval (IPI), defined as the time span from one delivery to the next conception, is a controllable component of postpartum family planning. Studies show IPI affects adverse outcomes in singleton pregnancies, but its impact on twin pregnancies remains unclear. Our study aimed to explore the relationship between IPI and maternal and neonatal outcomes in subsequent twin pregnancies and also identified risk factors for these outcomes.
We conducted a retrospective cohort study of 583 women with twin pregnancies from 2016 to 2023. They were categorized into five groups based on IPI: <24 months, 24–35 months, 36–59 months, 60–119 months, and ≥ 120 months. Primary outcomes included preterm birth < 34 weeks, low birth weight/low birth weight, low birth weight/normal birth weight, and very low birth weight or extremely low birth weight in at least one twin. Secondary outcomes were postpartum hemorrhage and maternal hemorrhagic morbidity. Logistic regression analyses were conducted to investigate the relationship between IPI and adverse outcomes, as well as the risk factors for these outcomes.
Women with an IPI of 36–59 months had a lower risk of very low birth weight or extremely low birth weight in at least one twin (aOR = 0.15, 95% CI = 0.03–0.81) compared to those with an IPI < 24 months. No relationship was found between IPI and other birth outcomes ( > 0.05). Modifiable risk factors including maternal body mass index at delivery, gestational weight gain, assisted reproductive technology, general anesthesia and anemia, along with unmodifiable risk factors including chorionicity, preterm premature rupture of membranes, gestational hypertension, preeclampsia, cesarean delivery history, placenta previa, low-lying placenta, and placental adherence, were related to adverse maternal and neonatal outcomes ( < 0.05).
An IPI of 36–59 months is a protective factor against very low birth weight or extremely low birth weight in at least one twin. No significant associations are found between IPI and other birth outcomes in women with subsequent twin pregnancies. Risk factors contributing to adverse perinatal outcomes should be considered.
妊娠间隔（IPI）定义为从一次分娩到下一次受孕的时间跨度，是产后计划生育中一个可控的因素。研究表明，IPI会影响单胎妊娠的不良结局，但其对双胎妊娠的影响尚不清楚。我们的研究旨在探讨IPI与后续双胎妊娠中母婴结局之间的关系，并确定这些结局的危险因素。
我们对2016年至2023年期间的583例双胎妊娠妇女进行了一项回顾性队列研究。根据IPI将她们分为五组：<24个月、24 - 35个月、36 - 59个月、60 - 119个月和≥120个月。主要结局包括至少一个双胎早产<34周、低出生体重/低出生体重、低出生体重/正常出生体重以及极低出生体重或超低出生体重。次要结局为产后出血和产妇出血性疾病。进行逻辑回归分析以研究IPI与不良结局之间的关系以及这些结局的危险因素。
与IPI<24个月的妇女相比，IPI为36 - 59个月的妇女至少有一个双胎出现极低出生体重或超低出生体重的风险较低（调整后比值比[aOR]=0.15，95%置信区间[CI]=0.03 - 0.81）。未发现IPI与其他出生结局之间存在关联（P>0.05）。可改变的危险因素包括分娩时的产妇体重指数、孕期体重增加、辅助生殖技术、全身麻醉和贫血，以及不可改变的危险因素包括绒毛膜性、胎膜早破、妊娠期高血压、子痫前期、剖宫产史、前置胎盘、低置胎盘和胎盘粘连，均与母婴不良结局相关（P<0.05）。
36 - 59个月的IPI是预防至少一个双胎出现极低出生体重或超低出生体重的保护因素。在后续双胎妊娠的妇女中，未发现IPI与其他出生结局之间存在显著关联。应考虑导致围产期不良结局的危险因素。
