Adams M M, Delaney K M, Stupp P W, McCarthy B J, Rawlings J S
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
Paediatr Perinat Epidemiol. 1997 Jan;11 Suppl 1:48-62. doi: 10.1046/j.1365-3016.11.s1.8.x.
To examine the association between interpregnancy interval and low birthweight (< 2500 g), preterm delivery (< 37 weeks' gestation), and inadequate fetal growth, we studied a population-based sample of 23,388 white and 4885 black women at low risk for adverse pregnancy outcomes who delivered their first and second infants in Georgia from 1980 to 1992. We used fetal death and livebirth certificates. The interpregnancy interval was the time from delivery to the woman's next conception. For each pregnancy outcome, we stratified by race and used logistic regression to assess the association between interpregnancy interval and outcome, while controlling for confounders. Intervals < 6 months were observed for 3.7% of white women and 7.0% of black women and intervals > or = 48 months were seen for 16.8% of white women and 24.8% of black women. Results from logistic regression showed that, for both races, interpregnancy interval was associated with low birthweight and preterm delivery. Nearly all of the increased risk occurred in intervals < 6 months or > or = 48 months. The magnitude of the increase in risk associated with these intervals ranged from modest to moderate and was similar for black and white women. Because short interpregnancy intervals are rare and are weak risk factors among low-risk women, efforts to lengthen interpregnancy intervals are unlikely to reduce substantially their rates of adverse pregnancy outcomes.
为了研究妊娠间隔与低出生体重(<2500克)、早产(妊娠<37周)和胎儿生长不足之间的关联,我们对1980年至1992年在佐治亚州分娩第一和第二个婴儿的23388名白人妇女和4885名黑人妇女进行了一项基于人群的抽样研究,这些妇女妊娠不良结局风险较低。我们使用了胎儿死亡和出生证明。妊娠间隔是指从分娩到妇女下次受孕的时间。对于每种妊娠结局,我们按种族进行分层,并使用逻辑回归来评估妊娠间隔与结局之间的关联,同时控制混杂因素。3.7%的白人妇女和7.0%的黑人妇女的妊娠间隔<6个月,16.8%的白人妇女和24.8%的黑人妇女的妊娠间隔≥48个月。逻辑回归结果显示,对于两个种族,妊娠间隔均与低出生体重和早产有关。几乎所有风险增加都发生在间隔<6个月或≥48个月的情况下。与这些间隔相关的风险增加幅度从中度到中度不等,黑人和白人妇女相似。由于短妊娠间隔在低风险妇女中很少见且是弱风险因素,延长妊娠间隔的努力不太可能大幅降低她们不良妊娠结局的发生率。