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Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study

BACKGROUND: Interpregnancy interval (IPI) has been linked with several maternal and neonatal adverse events in the general population. However, the association between IPI and maternal and neonatal outcomes in women whose first delivery was by cesarean delivery is unclear. We aimed to investigate th...

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Autores principales: Dong, Hong, Chi, Jinghan, Wang, Wei, Liu, Lei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10127338/
https://www.ncbi.nlm.nih.gov/pubmed/37098470
http://dx.doi.org/10.1186/s12884-023-05600-x
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author Dong, Hong
Chi, Jinghan
Wang, Wei
Liu, Lei
author_facet Dong, Hong
Chi, Jinghan
Wang, Wei
Liu, Lei
author_sort Dong, Hong
collection PubMed
description BACKGROUND: Interpregnancy interval (IPI) has been linked with several maternal and neonatal adverse events in the general population. However, the association between IPI and maternal and neonatal outcomes in women whose first delivery was by cesarean delivery is unclear. We aimed to investigate the association between IPI after cesarean delivery and the risk of maternal and neonatal adverse events. METHODS: Women (aged ≥ 18 years) whose first delivery was cesarean delivery with 2 consecutive singleton pregnancies from the National Vital Statistics System (NVSS) database between 2017 and 2019 were included in this retrospective cohort study. In this post-hoc analysis, logistic regression analyses were used to examine IPI (≤ 11, 12–17, 18–23 [reference], 24–35, 36–59, and ≥ 60 months) in relation to the risk of repeat cesarean delivery, maternal adverse events (maternal transfusion, ruptured uterus, unplanned hysterectomy, and admission to an intensive care unit), and neonatal adverse events (low birthweight, premature birth, Apgar score at 5 min < 7, and abnormal conditions of the newborn). Stratified analysis based on age (< 35 and ≥ 35 years) and previous preterm birth. RESULTS: We included 792,094 maternities, 704,244 (88.91%) of which underwent a repeat cesarean delivery, 5,246 (0.66%) women had adverse events, and 144,423 (18.23%) neonates had adverse events. After adjusting for confounders, compared to an IPI of 18–23 months, the IPI of ≤ 11 months [odds ratio (OR) = 1.55, 95% confidence interval (CI): 1.44–1.66], 12–17 months (OR = 1.38, 95%CI: 1.33–1.43), 36–59 months (OR = 1.12, 95%CI: 1.10–1.15), and ≥ 60 months (OR = 1.19, 95%CI: 1.16–1.22) were associated with an increased risk of repeat cesarean delivery. In terms of maternal adverse events, only IPI of ≥ 60 months (OR = 0.85, 95%CI: 0.76–0.95) was observed to be associated with decreased risk of maternal adverse events in women aged < 35 years. In analysis of neonatal adverse events, IPI of ≤ 11 months (OR = 1.14, 95%CI: 1.07–1.21), 12–17 months (OR = 1.07, 95%CI: 1.03–1.10), and ≥ 60 months (OR = 1.05, 95%CI: 1.02–1.08) were related to an increased risk of neonatal adverse events. CONCLUSION: Both short and long IPI were associated with an increased risk of repeat cesarean delivery and neonatal adverse events, and women < 35 years may benefit from a longer IPI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-023-05600-x.
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spelling pubmed-101273382023-04-26 Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study Dong, Hong Chi, Jinghan Wang, Wei Liu, Lei BMC Pregnancy Childbirth Research BACKGROUND: Interpregnancy interval (IPI) has been linked with several maternal and neonatal adverse events in the general population. However, the association between IPI and maternal and neonatal outcomes in women whose first delivery was by cesarean delivery is unclear. We aimed to investigate the association between IPI after cesarean delivery and the risk of maternal and neonatal adverse events. METHODS: Women (aged ≥ 18 years) whose first delivery was cesarean delivery with 2 consecutive singleton pregnancies from the National Vital Statistics System (NVSS) database between 2017 and 2019 were included in this retrospective cohort study. In this post-hoc analysis, logistic regression analyses were used to examine IPI (≤ 11, 12–17, 18–23 [reference], 24–35, 36–59, and ≥ 60 months) in relation to the risk of repeat cesarean delivery, maternal adverse events (maternal transfusion, ruptured uterus, unplanned hysterectomy, and admission to an intensive care unit), and neonatal adverse events (low birthweight, premature birth, Apgar score at 5 min < 7, and abnormal conditions of the newborn). Stratified analysis based on age (< 35 and ≥ 35 years) and previous preterm birth. RESULTS: We included 792,094 maternities, 704,244 (88.91%) of which underwent a repeat cesarean delivery, 5,246 (0.66%) women had adverse events, and 144,423 (18.23%) neonates had adverse events. After adjusting for confounders, compared to an IPI of 18–23 months, the IPI of ≤ 11 months [odds ratio (OR) = 1.55, 95% confidence interval (CI): 1.44–1.66], 12–17 months (OR = 1.38, 95%CI: 1.33–1.43), 36–59 months (OR = 1.12, 95%CI: 1.10–1.15), and ≥ 60 months (OR = 1.19, 95%CI: 1.16–1.22) were associated with an increased risk of repeat cesarean delivery. In terms of maternal adverse events, only IPI of ≥ 60 months (OR = 0.85, 95%CI: 0.76–0.95) was observed to be associated with decreased risk of maternal adverse events in women aged < 35 years. In analysis of neonatal adverse events, IPI of ≤ 11 months (OR = 1.14, 95%CI: 1.07–1.21), 12–17 months (OR = 1.07, 95%CI: 1.03–1.10), and ≥ 60 months (OR = 1.05, 95%CI: 1.02–1.08) were related to an increased risk of neonatal adverse events. CONCLUSION: Both short and long IPI were associated with an increased risk of repeat cesarean delivery and neonatal adverse events, and women < 35 years may benefit from a longer IPI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12884-023-05600-x. BioMed Central 2023-04-25 /pmc/articles/PMC10127338/ /pubmed/37098470 http://dx.doi.org/10.1186/s12884-023-05600-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Dong, Hong
Chi, Jinghan
Wang, Wei
Liu, Lei
Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
title Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
title_full Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
title_fullStr Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
title_full_unstemmed Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
title_short Association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
title_sort association between interpregnancy interval and maternal and neonatal adverse outcomes in women with a cesarean delivery: a population-based study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10127338/
https://www.ncbi.nlm.nih.gov/pubmed/37098470
http://dx.doi.org/10.1186/s12884-023-05600-x
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