Advertisement

Effects of birth spacing on maternal health: a systematic review

      The objective of the study was to explore the association between birth spacing and risk of adverse maternal outcomes. The study was a systematic review of observational studies that examined the relationship between interpregnancy or birth intervals and adverse maternal outcomes. Twenty-two studies met the inclusion criteria. Overall, long interpregnancy intervals, possibly longer than 5 years, are independently associated with an increased risk of preeclampsia. There is emerging evidence that women with long interpregnancy intervals are at increased risk for labor dystocia and that short intervals are associated with increased risks of uterine rupture in women attempting a vaginal birth after previous cesarean delivery and uteroplacental bleeding disorders (placental abruption and placenta previa). Less clear is the association between short intervals and other adverse outcomes such as maternal death and anemia. Long interpregnancy intervals are independently associated with an increased risk of preeclampsia. Both short and long interpregnancy intervals seem to be related to other adverse maternal outcomes, but more research is needed.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Rousso D.
        • Panidis D.
        • Gkoutzioulis F.
        • Kourtis A.
        • Mavromatidis G.
        • Kalahanis I.
        Effect of the interval between pregnancies on the health of mother and child.
        Eur J Obstet Gynecol Reprod Biol. 2002; 105: 4-6
        • King J.C.
        The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies.
        J Nutr. 2003; 133: 1732S-1736S
        • Erickson J.D.
        • Bjerkedal T.
        Interval between pregnancies.
        Lancet. 1979; I: 52
        • Winikoff B.
        The effects of birth spacing on child and maternal health.
        Stud Fam Plann. 1983; 14: 231-245
        • Klebanoff M.A.
        The interval between pregnancies and the outcome of subsequent births.
        N Engl J Med. 1999; 340: 643-644
        • Zhu B.P.
        • Le T.
        Effect of interpregnancy interval on infant low birth weight: a retrospective cohort study using the Michigan Maternally Linked Birth Database.
        Matern Child Health J. 2003; 7: 169-178
        • Stroup D.F.
        • Berlin J.A.
        • Morton S.C.
        • et al.
        Meta-analysis of observational studies in epidemiology: a proposal for reporting.
        JAMA. 2000; 283: 2008-2012
        • Levine M.
        • Walter S.
        • Lee H.
        • Haines T.
        • Holbrook A.
        • Moyer V.
        Users’ guides to the medical literature. IV. How to use an article about harm. Evidence-Based Medicine Working Group.
        JAMA. 1994; 271: 1615-1619
        • Downs S.H.
        • Black N.
        The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions.
        J Epidemiol Community Health. 1998; 52: 377-384
        • Singh K.
        • Fong Y.F.
        • Arulkumaran S.
        Anemia in pregnancy—a cross-sectional study in Singapore.
        Eur J Clin Nutr. 1998; 52: 65-70
        • Khan K.S.
        • Chien P.F.
        • Khan N.B.
        Nutritional stress of reproduction.
        Acta Obstet Gynecol Scand. 1998; 77: 395-401
        • Conde-Agudelo A.
        • Belizan J.M.
        Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study.
        BMJ. 2000; 321: 1255-1259
        • Shipp T.D.
        • Zelop C.M.
        • Repke J.T.
        • Cohen A.
        • Lieberman E.
        Interdelivery interval and risk of symptomatic uterine rupture.
        Obstet Gynecol. 2001; 97: 175-177
        • Basso O.
        • Christensen K.
        • Olsen J.
        Higher risk of pre-eclampsia after change of partner: an effect of longer interpregnancy intervals?.
        Epidemiology. 2001; 12: 624-629
        • Trogstad L.I.
        • Eskild A.
        • Magnus P.
        • Samuelsen S.O.
        • Nesheim B.I.
        Changing paternity and time since last pregnancy; the impact on pre-eclampsia risk.
        Int J Epidemiol. 2001; 30: 1317-1322
        • Huang W.H.
        • Nakashima D.K.
        • Rumney P.J.
        • Keegan Jr, K.A.
        • Chan K.
        Interdelivery interval and the success of vaginal birth after cesarean delivery.
        Obstet Gynecol. 2002; 99: 41-44
        • Skjaerven R.
        • Wilcox A.J.
        • Lie R.T.
        The interval between pregnancies and the risk of preeclampsia.
        N Engl J Med. 2002; 346: 33-38
        • Bujold E.
        • Mehta S.H.
        • Bujold C.
        • Gauthier R.J.
        Interdelivery interval and uterine rupture.
        Am J Obstet Gynecol. 2002; 187: 1199-1202
        • Dairo M.D.
        • Lawoyin T.O.
        Socio-demographic determinants of anemia in pregnancy at primary care level: a study in urban and rural Oyo State, Nigeria.
        Afr J Med Med Sci. 2004; 33: 213-217
        • Razzaque A.
        • Da Vanzo J.
        • Rahman M.
        • et al.
        Pregnancy spacing and maternal morbidity in Matlab, Bangladesh.
        Int J Gynaecol Obstet. 2005; 89: S41-S49
        • Da Vanzo J.
        • Razzaque A.
        • Rahman M.
        • et al.
        The effects of birth spacing on infant and child mortality, pregnancy outcomes, and maternal morbidity and mortality in Matlab, Bangladesh.
        World Health Organization. World Health Organization, Geneva (Switzerland)2005
        • Getahun D.
        • Oyelese Y.
        • Salihu H.M.
        • Ananth C.V.
        Previous cesarean delivery and risks of placenta previa and placental abruption.
        Obstet Gynecol. 2006; 107: 771-778
        • Zhu B.P.
        • Grigorescu V.
        • Le T.
        • et al.
        Labor dystocia and its association with interpregnancy interval.
        Am J Obstet Gynecol. 2006; 195: 121-128
        • Stürchler D.
        • Menegoz F.
        • Daling J.
        Reproductive history and intrapartum fever.
        Gynecol Obstet Invest. 1986; 21: 182-186
        • Anandalakshmy P.N.
        • Talwar P.P.
        • Buckshee K.
        • Hingorani V.
        Demographic, socio-economic and medical factors affecting maternal mortality—an Indian experience.
        J Fam Welfare. 1993; 39: 1-4
        • Ronsmans C.
        • Campbell O.
        Short birth intervals don’t kill women: evidence from Matlab, Bangladesh.
        Stud Fam Plann. 1998; 29: 282-290
        • Fortney J.A.
        • Zhang J.
        Maternal death and birth spacing.
        Stud Fam Plann. 1998; 29: 436
        • Wax J.R.
        • Seiler A.
        • Horowitz S.
        • Ingardia C.J.
        Interpregnancy interval as a risk factor for placenta accreta.
        Conn Med. 2000; 64: 659-661
        • Mostello D.
        • Catlin T.K.
        • Roman L.
        • Holcomb Jr, W.L.
        • Leet T.
        Preeclampsia in the parous woman: who is at risk?.
        Am J Obstet Gynecol. 2002; 187: 425-429
        • Esposito M.A.
        • Menihan C.A.
        • Malee M.P.
        Association of interpregnancy interval with uterine scar failure in labor: a case-control study.
        Am J Obstet Gynecol. 2000; 183: 1180-1183
        • Orji E.O.
        • Shittu A.S.
        • Makinde O.N.
        • Sule S.S.
        Effect of prolonged birth spacing on maternal and perinatal outcome.
        East Afr Med J. 2004; 81: 388-391
        • Dicle O.
        • Kucukler C.
        • Pirnar T.
        • Erata Y.
        • Posaci C.
        Magnetic resonance imaging evaluation of incision healing after cesarean sections.
        Eur Radiol. 1997; 7: 31-34
        • Winkvist A.
        • Rasmussen K.M.
        • Habicht J.P.
        A new definition of maternal depletion syndrome.
        Am J Public Health. 1992; 82: 691-694
        • Smits L.J.M.
        • Essed G.G.M.
        Short interpregnancy intervals and unfavourable pregnancy outcome: role of folate depletion.
        Lancet. 2001; 358: 2074-2077
        • Khan K.S.
        • Mignini L.
        Surveying the literature from animal experiments: avoidance of bias is objective of systematic reviews, not meta-analysis.
        BMJ. 2005; 331: 110-111